Winter is never greeted with anything resembling enthusiasm in the NHS, but this winter seems to have presented a series of unprecedented challenges.
The threat of a ‘twindemic’ of flu and COVID may have been priced in by some policymakers, but historic strikes by paramedics and nurses, a Strep A outbreak which has so far claimed the lives of 15 children, and a cost of living crisis which has pushed millions of people into fuel poverty cannot have been. It seems like the mythic ‘Perfect Storm’ of factors.
But the galling thing is that is a storm whose components have been assembling for a long time. To borrow a phrase used about the decline of Detroit, it is a ‘Slow-Motion Katrina’. The chain of factors that has led to a huge drop in the value of nurses’ pay and thus staff shortages was set in train by austerity 12 years ago, and exacerbated by bad workforce planning – we just don’t train enough people and have made it steadily more financially difficult for the ones we do.
The pressure on acute services, has its roots in the crisis in social care funding and the workforce gaps we report upon on page 6 in this issue. Our system has been running on staff goodwill and (until COVID at least) a certain amount of good luck. Now it seems both have run out.
What is to be done? More money would be welcome but a change of emphasis is what is really needed. We need a health and social care system not based around funnelling our problems into Big Hospital but catching them in social care and primary care first. It’s not a quick fix, but maybe our current travails will concentrate minds into making it happen.