Frontline accident and emergency staff have revealed the shocking conditions they have been working in as the NHS faces its most severe Winter crisis in years.
Doctors and nurses told HuffPost UK this week of unprecedented pressures on A&E, including patients waiting 10 hours to be seen by a doctor and stressed staff using their own hospital’s mental health services.
Struggling hospitals were told on New Year’s Day to cancel all routine surgery until the end of January amid fears of a meltdown, with doctors and nurses told to focus on the sickest patients. It is thought as many as 55,000 operations have been affected.
Now NHS workers have spoken of their experiences on the frontline of A&E over the past two weeks.
Dr Adrian Harrop
Adrian is an A&E doctor at Scarborough Hospital in North Yorkshire
“This year, with the current degree of winter pressure that we are feeling, this is the worst condition that I have ever seen the NHS in.
“A&E is not a destination in itself, it is like a sorting office.
“When I come onto the unit and I see the management disaster that the senior nurses in the department are responsible for sorting out, I feel desperately sorry for them because there is nothing they can do to help that situation.
“[Senior nurses] are dealing with patients that have been there for an entire day in A&E.
“These are patients who are meant to be in and out of the department within the space of four hours… and we feel like we are failing… and we can’t do anything to stop the ship from sinking.
“Everyone is working as hard as they possibly can, bailing water out of the Titanic with a bucket, but ultimately everyone can see the ship is sinking.”
“[On Wednesday morning] the department was completely jam-packed. Every single cubicle within our department... was filled with a patient.
“We then have patients backing up on the corridor, waiting to go in to those cubicles as and when those cubicles become available.”
“The patients who are at the front of the queue waiting to be seen next have been waiting 10 hours to see a doctor because there’s no space to see them in.”
The patients who are at the front of the queue waiting to be seen next have been waiting 10 hours to see a doctor. Dr Adrian Harrop
“I’ve seen multiple colleagues in tears at work.
“These are very resilient, highly experienced, senior colleagues who have been reduced to tears because they are completely broken by the pressure that they are under.”
“I have seen so many staff really being driven to breaking point by what’s happening.”
“I had a patient who came to me yesterday who, during the course of the afternoon, had developed chest pains.
“Now she was concerned and worried that because A&E is facing such a crisis she didn’t want to bother anyone with that.
“She phoned her GP and the GP was unable to see her because there were no appointments available.
“She called an ambulance.. called 111 and was told she could be waiting up to four or six hours for an ambulance to come so she told them not to bother.
“She was driven up to A&E and sat two and a half hours until we were able to see her.
“Now this woman had ongoing chest pains all the time and when I finally got her to my assessment cubicle, into my one cubicle I had left on my A&E department, she broke down in tears and said to me ‘doctor I am so sorry for bothering you, I just don’t want to add to the pressure you are already feeling’.
“And I nearly started crying when she said that.”
Sarah is a mental health nurse in Greater Manchester.
“A&E is becoming a refuge, rather than somewhere that treats acute illnesses. It’s becoming a treat-all - the GP surgery, the drop-in centre, a place for homeless people when they have nowhere else to go.
“But people don’t come because they want to spend six hours in an A&E department. They come because they’re desperate for care.
“During most shifts it gets to saturation point where all the beds on the wards are full and people start to cram up in A&E. There’s people waiting in corridors and bed managers are frantically trying to move people around and discharge others early.
“What we are doing now is basically putting out fires. We’re not actually providing the care we should be to these patients. We’re trying our hardest and we’re scraping through by the skin of our teeth. But there’s only so long that’s going to last for.
As a mental health nurse, I’m now actually talking to staff because they’re getting so stressed out by the pressure. Sarah*, mental health nurse
“Mistakes are going to be made and the people who will get blamed are the frontline staff. But they’re running their arses off - they’re working so hard.
“I work an 11 and a half hour shift and it’s very, very rare I ever get a break. There’s just not the provision for us to take breaks. I usually eat my lunch in my car on the way home.
“It all takes a toll from a psychological point of view. As a mental health nurse, I’m now actually talking to staff because they’re getting so stressed out by the pressure.
“People are suffering from anxiety, people are suffering from depression and people are going off sick. It’s just a powder keg at the moment.”
Dr Lucie Cocker
Lucie is chair of the BMA Yorkshire junior doctors committee and works in A&E.
“My shifts tend to be 10 hours long and it’s not just physically being on my feet and running around, it’s trying to balance everything, trying to balance patients.
“There are so many patients coming in. Many of them waiting far longer than they should be and, obviously, they are in pain and unwell and we want to be seeing them, but we also don’t want to be rushing anyone or missing anything.
“It doesn’t just drain you while you are at work, you have those thoughts when you get home... is there anyone or anything that got missed, and that plays on your mind.”
“By the time I’m finished I’m just absolutely exhausted.”
“There are shifts where I think ‘why do I put myself through this’. And the reason is that when we have a good shift I really enjoy it. I do really enjoy looking after my patients but there are times where I get home and I am absolutely shattered, and I have had an awful shift with a really upsetting situation.”
There are a lot of patients sitting on chairs in the corridors as well as being in the cubicles. Dr Lucie Cocker
“When I arrive on shift I normally try to walk through the department waiting room just to get a feel of what it’s going to be like on the shift before I go and get changed into my scrubs.
“And at the moment the waiting room is absolutely heaving, a couple of times there will be people standing in the waiting room as well as the people in wheelchairs and the permanent chairs.
“And that kind of gives you a sense of the foreboding of the situation and the shift to come... and coming into the department we have had a lot of temporary partitions in cubicles so that we can have more than one person in a cubicle.
“There are a lot of patients sitting on chairs in the corridors as well as being in the cubicles. A lot of the staff are obviously very, very busy.
“It’s trying to get through the patients as quickly as we can so that people aren’t waiting too long, but not making people feel like they are not getting the attention while they are being seen.”
Jill is nurse from west London with 10 years NHS experience.
“It’s a relentless kind of pressure in A&E at the moment- from the second you go in in the morning until the second you go home, it’s just one after the other after the other. There’s no respite from it.
“I started at 7am yesterday. They had had a really busy night, so the whole resus [resuscitation] room was a complete mess and there were still patients in there from the night before waiting for beds.
“You go in and you have to clean and stock all that up while also looking after your patient. Before you have even had time to think, you will end up receiving a blue call [a warning of what cases are coming in by ambulance].
What we used to consider a busy day 10 years ago, with around 30 patients in the department, is now quite a nice day. These days, we regularly have 50 or 60 Jill*, west London nurse
“So it’s like you’re always playing catch up, from the minute you start. You’re never as far ahead as you want to be.
“And pressure is increasing year on year. What we used to consider a busy day ten years ago, with around 30 patients in the department, is now quite a nice day. These days, we regularly have 50 or 60.
“You do worry you’re not giving people the care they deserve. You’re giving people the bare minimum you can manage to give - not what you would like. It’s not what you go into nursing for.
“If somebody said to me now that they wanted to go into nursing, I would say: ‘Don’t’.”
Mark is a nurse who works at a central London hospital on a ward unit attached to A&E, where he has worked for three years.
“Where we maybe had five or ten beds free empty at any time, now we are pretty much full all the time. It’s like one in, one out. As soon as someone gets discharged, there’s someone coming into the bed.”
“You can sometimes see decisions being made based on freeing up beds rather than a patient’s need.
“That is demoralising and the fact that it’s going to get worse is going to lead to people wanting to leave [the profession].”
You can sometimes see decisions being made based on freeing up beds rather than a patient's need. Mark*, central London nurse
“We are one of the central London trusts. We have a lot of funding, we are able to get patients home a lot quicker than other trusts, we aren’t having ambulances queuing outside as quickly as other places, but when all the other hospitals get full, they come to us.
“We are getting to the point now where we are being told there are no beds in the hospital.”
“If we have no beds then there’s no beds anywhere else because we are a thousand-bedded hospital, we usually have the capacity and services to create space.
“If it gets any worse we are going to face a serious crisis.”
*Some names have been changed to protect the identity of NHS workers.