Royal College of Physicians (RCP) president Professor Jane Dacre has written to chief executives and medical directors of NHS trusts with guidance on how to mitigate winter pressures. The Preparing for winter guidance covers the delivery of care, patient flow, wellbeing of the workforce and minimising unnecessary hospital occupancy.
Professor Dacre is worried that patients and clinical staff will bear the brunt of the likely surge in admissions over the winter, against a background of rota gaps, leading to poorer care and low morale, and the RCP is determined to minimise the impact on patients.
Professor Dacre says in the letter:
As winter approaches, the media is full of concerns that the NHS is headed for a crisis. But for health and social care providers, we know the reality is a worrying picture all year round. The NHS remains underfunded, underdoctored, overstretched, and together we deal with the impact every day.
Our 2016–17 census found that 55% of consultants frequently or often have a trainee gap in their rota. But three quarters of them said they could usually find a workaround solution. When it comes to patient safety, we shouldn't have to work around low staff numbers and inadequate funding. We will continue to talk to government about our four-point plan, making the case for investing in the NHS workforce, health and social care services, and public health.
The guidance will also be issued to the RCP’s 34,000 members – as Professor Dacre stresses in her recent blog, The perennial winter: solving the workforce crisis:
Chief executives, medical directors, managers and physicians of all specialties need to work together to ensure that the necessary systems are in place. In particular, they need to make sure that physicians providing specialty rotas alongside the general take* are able to deliver responsive 7-day services.
The RCP also wants to hear from its members and health service managers about their experiences of winter, as it did for NHS reality check: Delivering care under pressure, the document produced early in 2017 outlining doctors’ experiences of the situation.
*Medical patients make up the majority of acute unscheduled admissions to most NHS secondary care hospitals. The acute or general medical take refers to the admission of very ill patients to the acute medical unit, either directly or via the emergency department. One third of all hospital admissions are via the acute medical take.
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