Corridor care in Wales must end

Dr Altaf Hussain MS

I’ll begin by referring readers to my comments made during the Covid-19 pandemic period, “Good health is the cornerstone of our society”.

MSs regularly receive constituent correspondence detailing their traumatic, sub-standard level of clinical care. Unacceptably, I know on one occasion, a diabetic patient (73 years old) with no offers of food, sitting suffering in a chair from Christmas Eve through to Boxing Day at Morriston Hospital. Awful.

Like Llais recently reported, “The system is broken but the staff are fantastic.” Understandably, nurses are affected by these highly stressful working conditions, creating an atmosphere of dread or anxiety – with testimony that “Many staff cry regularly on shift and are actively looking at leaving the NHS and working for private companies or leaving the profession altogether.”

Dire

If nurses are telling us the situation is dire, we should listen and act. It’s imperative Senedd Members signify support to these frontline workers; agreeing a motion to take note of Royal College of Nursing’s recent recommendations like labelling +24hr chair care as a “never event”.

Over many years as an NHS-employee, I’ve never seen this type of shocking scene – patients feel increasingly invisible, discarded, as anonymous faces scurry busily by.

I’ve straightforwardly stated: “we are not only letting down patients; it’s a dereliction of our duty to NHS staff. Without their herculean efforts we wouldn’t have a health service.”

I’ve highlighted my own experience as an NHS orthopaedic consultant working in hospitals across England and Wales. During these times every emergency department would’ve had observation wards, theatres, and treatment bay – patients were never treated in the waiting room nor in the corridors.

Ill equipped

Welsh Conservative colleagues unsuccessfully urged fellow MSs adopt an unamended motion to take up recent recommendations as advocated bravely by RCN’s expert perspective; given it is utterly unacceptable corridor care happens at all let alone on such a regular basis that has forced the RCN to call it out.

66.8% of respondents to the RCN survey say they’ve delivered corridor care, when we should see none at all – nurses now wonder why our hospitals are ill-equipped and why we have thousands fewer beds in our hospitals.

Disappointingly, Health Board leaders repeatedly reassure me that this isn’t happening at our hospitals, when we know it is! Further, winter pressures are nothing new they happen every year. There is always a surge in patients when the weather gets colder.

I’ve continuously challenged Welsh Labour Health Ministers both as an NHS Doctor and now as an elected politician stating that Bevan’s concept and spirit of National Health Service should reign supreme above self-interest, group interest and political interest.

Questions

I’ve repeatedly raised questions about how many doctors are on duty at any one time in A&Es across Wales, if the staffing levels are adequate why are patients kept in ambulances and the queues keep growing?

Senior leadership at Government and Health Board-level are at fault for poor planning. The lack of a comprehensive NHS workforce plan for the past quarter of a century being the number one culprit.

We have legislation which dictates safe nursing levels but nothing to ensure we have a safe number of clinicians operating our EDs, as a result we are forcing nursing staff to deal with the delays in treatment and forcing patients to wait in pain and discomfort.

The NHS is fighting a losing battle trying to deliver an adequate standards of care people deserve, RCN Wales Director Helen Whyley aptly arguing: “people are being treated in unsafe, undignified and unacceptable environments.”

With people living longer this may mean more people with ill-health. I’ve regularly referred to the triangle of physical, mental and social elements being balanced as argued broadly by WHO in its definition of stable health being freedom from not merely “the absence of disease or infirmity.”

Treatment

Responding to these emergent if critical challenges, NHS should start by becoming;

• • Holistic, seeing a patient as a whole. We’ve enjoyed dramatic improvements in average life expectancy, per capita income, literacy, communications plus transport – there is no doubt that new approaches like to life brought us spectacular gains but over the years we also lost balance in our lives.
  • Prioritising patient treatment – a patient may have multiple problems or only one, with many effects e.g. missing diagnoses of arthritis of the hip when complaining of knee pain.
  • Ensuring continuation of care.

2024’s plan for health & social care explicitly advocated a person-centred service supporting “timely” clinical care, plus providing the “very best care for patients at all times through the performance, oversight and escalation framework.”

Nobody can claim that this has happened. People do not attend a hospital out of choice, particularly knowing how long waits are at A&E, those that do go are amongst most frail and requiring timely treatment.

Accountable

Welsh Ministers cannot continue hiding behind austerity as a get-out-of-jail card, criticising any attempt to hold them accountable when news outlets report shocking stories of poor care.

We have to build our way back to health. I’ve strongly supported “stay at home assessments as integral to this, utilised upon reaching retirement for preventative planning longer-term but beginning firstly when we are all more mobile at age 67 – we find that more and more people want the opportunity to live in their homes for as long as they possibly can.

“Corridor Care” is the latest symptom of malaise at the top of our NHS whereby poor leadership and poor planning are impacting care and affecting the morale of frontline staff, including increasing mortality. Listening to the RCN, and adopting their latest recommendations will go some way to helping address the issues impacting staff and patients alike.

Dr Hussain is a retired consultant orthopaedic surgeon. He is a Regional Member of the Senedd for South Wales West and is the Shadow Cabinet Secretary for Equalities & Social Justice.