It’s rare access. To allow Sky News cameras into a hospital as it struggles through another winter crisis.
How did we know there would be one when we began filming in early December? Easy. There’s a crisis every winter in the NHS. And we knew it would be bad, but didn’t know quite how bad.
That was the issue we wanted to explore. We always know winter is coming and that hospitals, in this case the Royal Berkshire in Reading, like almost every acute site in England, will struggle. But as this is a given, surely there must be a way of preventing it from happening again and again?
The answers, straight from the mouths of the some of the hospital’s most experienced frontline clinicians, are surprising. Some are shocking.
Dr Omar Nafousi is the clinical lead at Royal Berkshire’s A&E, one of the busiest in the southeast of England. He’s worked here for years and says this winter is the “busiest by far”.
And the reason? Because the emergency department waiting room has been full of people who simply do not need to be there, Dr Nafousi says.
He explains: “I see people who don’t need to be here, I see people who need to be here but have come here a bit late, I’ve seen people who are just concerned, I see people sent by their friends because their friends are concerned, there’s a combination of all this.
“There’s a lot of anxiety after COVID and we’ve seen that.
“Young people with chest pain which they’ve had for a few minutes and are concerned they’ve had a heart attack.
“There’s a lot of little things which before would have been nothing but now are something.”
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In other words, Dr Nafousi wants his department to deal with real emergencies. The people who do not need to be there are driving up the patient numbers – and wait times.
The A&E’s doors are always open. Patients who cannot turn to another service, or wait to be seen, turn up here. They do so knowing that sooner, or usually much later, they will receive medical care. But that could all change.
If Dr Nafousi’s comments seem controversial, his A&E colleague Dr Jane Brenchley, also a consultant and clinical lead, has views that make for even more difficult reading.
She believes the time will soon come when A&E doors will no longer be open to anyone and everyone.
“As other services fall apart, or are perceived to be more difficult to access, more people end up here because it’s just the easy option,” she says. “You know if you turn up, you’ll be seen. We may get to the stage where actually we’re just looking at people and saying, ‘This isn’t an emergency’.”
You don’t usually hear senior clinicians saying this. They might think it privately but rarely voice these views in TV interviews.
These views about anxiety and the “walking well” are echoed by the hospital’s partners in primary care.
Dr Amit Sharma runs four surgeries near the hospital. He shows me data that points to a post-pandemic surge in demand for GP appointments.
Pointing to a line on a graph on his laptop, he explains: “November 2018 you can see it was around 27 or 28 million, and here you can see last month, it’s peaking almost at 40 million.”
I ask him what’s driving it. “That’s got to be around anxiety, that’s what we see every day. People are more fearful and anxious about their health.”
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It’s not just people who are more aware of their health, I ask.
“Awareness, absolutely,” he replies. “And some of that awareness is needed to capture cancers etc.
“But I think what our concern is, is that we’re seeing young people coming in actually with self-limiting illnesses or symptoms that are physical related to mental health conditions.”
These frank observations will be hard for patients to digest. Especially those who can’t get to see their GP or have to wait for hours in A&E.
Yes, it’s true this winter has been extremely difficult with flu, norovirus and other winter viruses peaking high and early.
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And the late discharge of patients without social care packages, crumbling NHS estates and crippling staffing issues continue to add pressure to the health care system.
But the NHS has to face another challenge: changing the mindset of patients who demand urgent and immediate care when it is not always what they need.
