When The system breaks: England A&E in crisis

Robert Colvile for The Telegraph explore in deep the NHS world, highlighting the pressures on A&E with this reportage that start from the Queen Elizabeth Hospital, the best structure in the National Health System.
As the NHS faces its worst winter in years, Robert Colvile provides an in-depth, first-hand account of the pressures facing the health service

If you want to tell the story of the NHS, there are a million places to start. You could start with the politics – Labour attempting to “weaponise” the issue ahead of the election, the Tories to defuse it. You could start with the money – the struggles over scarce resources, the debates over how many more billions will be needed as the population ages. Or you could start with the individual stories – with the people passing through the lobby of the Queen Elizabeth Hospital in Birmingham, one cold December morning. The girlfriend feeding crisps to a paralysed young man. The white-haired lady lingering over her tea, complaining as she stands up. The young family, sitting together, heads bowed. The little girl, horizontal in a wheelchair, breath mask clamped to her face, being wheeled out by her father.
But here’s where I’m going to start: in a small green-painted room off one of the main corridors of that same hospital, where 10 women and two men are studying the spreadsheet projected on the walls and firing jargon back and forth.
“Four in urology with a decision to admit.” “306 is gone, 728 still waiting.” “With all that agreed, does that give you any ITU capacity?” “They’re desperate to bring the liver over from Worcester.” “Time to be seen is at 1hr 54.”

This is the “Ops Centre” of one of the country’s biggest hospitals, where I am spending the week as a fly on the wall. At this and other daily bed meetings, the senior nurses and managers get together to work out who is in the hospital, and where they need to go next. They go through, ward by ward, listing spare beds and allocating them to the people in A&E. They can see who’s been waiting longest, where the pressure points are, and what needs to be done to resolve them.

This, then, is the story about the NHS that I want to tell. It’s the story of the NHS as a system – a system that takes millions of patients through from the GP surgery and A&E department to treatment, recovery and discharge.
It’s the story of how that system is starting to creak and increasingly crack under the strain. And hopefully, it might also be the story of how we can fix it.

READ MORE: The Telegraph

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