NHS under “intolerable and unsustainable” pressure


Deteriorating pay and conditions alongside increasing workloads has pushed NHS staff to "breaking point"

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Image by Simon Walker / No 10 Downing Street

By Ceri Hughes

The National Health Service has been subject to years of mounting pressure as several factors work cumulatively to push Britain’s healthcare system harder than ever. The key issues facing the NHS are its inability to discharge recovered patients, the increasing number of emergency attendants, the inadequacy of mental health provision, and major understaffing of medical professionals.

These factors have had severe consequences on the quality of patient treatment and the health of our NHS workers. The head of the NHS has warned that the health system is under more ‘extreme pressure’ than it was at the height of the pandemic. The British Medical Association (BMA) claims that the demand on the NHS is intolerable and unsustainable.

As a student nurse at the University of York, India Shearer observes the demanding and emotionally exhausting environment and states that the “People working within the NHS are at breaking point”. India further claims that the rising number of patients waiting to be discharged has turned the corridors into a temporary emergency department.

On 15 December 2022, Britain witnessed a major walkout of nurses. The Royal College of Nursing declared that further industrial action will take place in February. NHS providers have expressed concern over the strikes and have urged the government and unions to begin negotiations. The strikes have proved disruptive and exacerbate the existing pressure that bears down on Britain’s health system. The cost-of-living crisis and below-inflation pay awards have led to wide-scale frustration among nurses, and industrial action is symptomatic of a stressed work-force.

Nouse spoke to Dr Mike Parker, Associate Professor of Emergency Nursing at the University of York, who explained the effect this will have on Student nurses, “There will be extra pressure on students, working in demanding conditions without the full team”. Dr Parker was clear that nursing students will still be under supervision by a qualified nurse but warns that “learning during a time of national strike will not be as fruitful”.

An increasing shortfall of medical professionals, particularly nurses and doctors, has had hazardous effects. The NHS faces the largest staffing catastrophe in its 74-year history, and patients risk waiting up to 24 hours for emergency care. Concerns surrounding staffing continue to grow as nursing applications to UCAS drop 25 percent nationally. This presents an issue for the NHS since university nursing students are part of the government’s workforce planning.

The BMA has declared that the number of doctors per 1,000 people is insufficient, with an average doctor-to-patient ratio of 2.9 for every 1,000. This falls below the OECD EU average of 3.7.

The NHS is existing in the spectre of Covid-19, already severely over-stretched from the damage of the pandemic. The BMA states the condition of the health system has led to poor retention of NHS staff as mental health issues have become the highest reported cause of employee loss.

University professionals have raised concerns following Downing Street’s failure to rule out using student nurses to ease staff shortages. Dr Parker, comments on this, “Students attend hospital placement as a learning experience, they are not qualified with the knowledge and expertise to look after patients.” Dr Parker was adamant that students should not ‘back-fill’ a registrant work-force, claiming that is not in the “public interest”.

In York, pressure on emergency departments has required extraordinary action. There have been more than 1,000 people attending the emergency department a day. Stephen Eames, the Chief Executive of the Humber and North Yorkshire Health and Care Partnership (HCP) responds to this by stating “we are working together, as partners in health and care, across the Humber and North Yorkshire to address some of the key challenges in our system.” Eames commits to prioritise a recruitment drive across health and social care and extra discharge rounds to ensure patients are not in the hospital any longer than necessary.

The York and Scarborough Teaching Hospitals NHS Foundation Trust has received positive responses despite the demanding environment. An anonymous neurology patient left a rewarding review stating, “I saw a team that was under an immense workload and pressure, however, the professionalism, respect, and compassion shown towards patients in this busy department was exemplary”.

India further expanded on the toll NHS pressure is having on student nurses like herself. “We are burnt out. Working 12 hours in the hospital wards under the current circumstances is exhausting. Staff shortages are pushing students into situations that we are underqualified for.” Dr Parker commends student nurses for their “sterling job” and says they ought to be highly rewarded. He urges nursing students or any medics to reach out for support if they are struggling in these critical times.