The realities of winter: discussing the impact of pressures on NHS staff and patients

The RCP has been looking at the realities of working in the NHS this winter through a poll of its members. Here, specialty trainees Dr Matthew Roycroft and Dr Megan Rutter, talk of the impact of ‘winter pressures’ on staff, the other on patients. Both have stories to tell of tears shed. 

Matthew: I’m lucky enough to be working in a hospital that has prepared well for winter, however it is still taking a significant toll on both patients and staff. A recent acute take shift admitted the same number of patients in 12 hours as would usually come in over a 24 hour period. 

I’ve had really sick patients unable to move to intensive care as there wasn’t any availability in the region; and clinics have been cancelled last minute due to the trust being at OPEL (Operation Pressure Escalation Level) 4 (signifying the organisation is “unable to deliver comprehensive care”). But the worst moment I’ve had this winter was the message from one of my managers: “your junior is in tears.”

I care about my team and yet I didn’t know, I felt gutted. Usually I’m able to take some time in my day to ‘check in’ with juniors on my team, to see how they are doing, have a chat, catch up on patient progress and even take time to have a coffee break together when work allows, however with the increased demands on us all I hadn’t had time for this. 

But the worst moment I’ve had this winter was the message from one of my managers: “your junior is in tears.”

Dr Matthew Roycroft, specialty trainee

I was too wrapped up in dealing with the increasing numbers of patients to see the effect this was having on everyone else, the extra workload this was putting on us all. We can all work at a high intensity for a day or two but the amount of extra work being created was simply too much and, despite the trusts best efforts and offers of money, there simply weren’t any more clinical staff to bring in to help!

Megan: Unfortunately the problems Matthew describes are replicated throughout the country. Jim,* a robust gentleman in his 70s really brought home for me how bad the situation is at times and the consequences this can have for patients. I was in the middle of a run of nights, the trust were out of medical beds, patients were stacked on trolleys in A&E and I was having to see patients in non-clinical rooms as they were the only private spaces available.

Jim was unwell but almost immediately upon seeing him he simply broke down in tears telling me how for the last few hours the frail elderly lady next to him on the corridor with a possible fracture had been crying out. Through the tears he told me how the nurses had been fantastic and tried so hard to help this lady but seeing how helpless they were to get her a bed or make her comfortable was so unfair. He’d heard about winter in the NHS but hadn’t really believed it. 

Sometimes we can become desensitised to winter, see patients in corridors as almost ‘normal’ but then you get someone like Jim who makes you refocus on what’s really important and highlights just how unacceptable this kind of situation is for either patients or staff.

Dr Matthew Roycroft is an ST6 geriatric and general internal medicine at Yorkshire and the Humber hospital. You can follow him on Twitter at @MattRoycroft

Dr Megan Rutter is an ST5 rheumatology and general internal medicine at West Midlands hospital

*Name changed for anonymity