Tag Archives: forced

I’m an A&E doctor. This is how we’re forced to let our patients down | Anonymous

I’ve arrived five minutes early for my shift in a hospital A&E department. I walk through the corridor behind the department, already crammed with hospital trolleys. I shut them out of my mind. I’ve still got five minutes of breathing space before they become my immediate reality.

The trolleys are staffed by paramedics. They brought the patients in, there’s nowhere for them to go, and there are no hospital staff to look after them. So the paramedics wait with the patients, checking on their pain and repeating their vital signs – instead of being out there responding to the soaring number of emergency calls.

Q&A

Why is the NHS winter crisis so bad in 2017-18?

A combination of factors are at play. Hospitals have fewer beds than last year, so they are less able to deal with the recent, ongoing surge in illness. Last week, for example, the bed occupancy rate at 17 of England’s 153 acute hospital trusts was 98% or more, with the fullest – Walsall healthcare trust – 99.9% occupied.

NHS England admits that the service “has been under sustained pressure [recently because of] high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es”.

Many NHS bosses and senior doctors say that the pressure the NHS is under now is the heaviest it has ever been. “We are seeing conditions that people have not experienced in their working lives,” says Dr Taj Hassan, the president of the Royal College of Emergency Medicine.

The unprecedented nature of the measures that NHS bosses have told hospitals to take – including cancelling tens of thousands of operations and outpatient appointments until at least the end of January – underlines the seriousness of the situation facing NHS services, including ambulance crews and GP surgeries.

Read a full Q&A on the NHS winter crisis

Most of the patients in the corridor today are elderly. Some clearly have dementia, and are confused as to where they are. There’s no dignity, no warmth and a very long wait ahead before the hospital starts seeing and treating them. It turns out that I didn’t manage to shut them out of my mind at all.

As I walk into the changing rooms there is chaos everywhere. A crisis has hit all the staff. The cleaners have needed to help with getting cubicles and bed areas turned around faster and faster, so the staff areas have moved to the bottom of their list. There are literally no clean scrubs or uniforms left for any of us to wear. “Don’t worry, whatever you’ve got on is fine, just start seeing patients.” The bosses are as stretched and as desperate as anyone else.

I am allocated to the “minors” area. This area was designed for ambulatory patients who could be walked into a room, seen and walked back out to the waiting room to wait for results. It is already full of patients on hospital beds, pushed two together in three out of the five consultation rooms. Some are elderly, confused, alone. Some are young, injured or very unwell. One is a mental health patient with severe anxiety. This is not the place to make her feel better. Far from it.

Over the PA system, pre-alerts for ambulances carrying critically unwell patients are announced – the ones whose condition is life-threatening. In 11 minutes, four ambulances carrying patients who need immediate resuscitation arrive. This would saturate the system on a good day. Today they have nowhere else to go.


The inadequate care we are providing is the inevitable reality of the government’s funding decisions

I hear a call for “security urgently” over the PA system. The call is repeated two minutes later. We all know it’s for show. The security team are stretched and scattered all over the hospital, and can rarely answer those calls. This time a staff member had been attacked by an intoxicated patient.

As I walk back down the jammed corridor, increasing numbers of screaming and crying patients line the lanes, creating an emotional and physical obstacle course that every staff member walks down. It’s truly sickening.

What’s worse is that this situation was entirely predictable. The inadequate care we are providing is the inevitable reality of the government’s funding decisions. If you strip back funding, force hospitals to make savings they can’t afford, devastate primary and social care, and fail to invest in staffing or resources to match demand, we are forced to tell our patients: “I’m so sorry, we can’t look after you safely today.”

And for many of us, we’re tired of apologising on behalf of the ministers who have made these decisions. It’s just too much. We are too tired to keep trying to smile. We are struggling to try to make it work. We’re sorry we’ve let you down, but we’re broken and we need your help.

The anonymous writer is an A&E doctor who works in a hospital in south-east England

I’m an A&E doctor. This is how we’re forced to let our patients down | Anonymous

I’ve arrived five minutes early for my shift in a hospital A&E department. I walk through the corridor behind the department, already crammed with hospital trolleys. I shut them out of my mind. I’ve still got five minutes of breathing space before they become my immediate reality.

The trolleys are staffed by paramedics. They brought the patients in, there’s nowhere for them to go, and there are no hospital staff to look after them. So the paramedics wait with the patients, checking on their pain and repeating their vital signs – instead of being out there responding to the soaring number of emergency calls.

Most of the patients in the corridor today are elderly. Some clearly have dementia, and are confused as to where they are. There’s no dignity, no warmth and a very long wait ahead before the hospital starts seeing and treating them. It turns out that I didn’t manage to shut them out of my mind at all.

As I walk into the changing rooms there is chaos everywhere. A crisis has hit all the staff. The cleaners have needed to help with getting cubicles and bed areas turned around faster and faster, so the staff areas have moved to the bottom of their list. There are literally no clean scrubs or uniforms left for any of us to wear. “Don’t worry, whatever you’ve got on is fine, just start seeing patients.” The bosses are as stretched and as desperate as anyone else.

I am allocated to the “minors” area. This area was designed for ambulatory patients who could be walked into a room, seen and walked back out to the waiting room to wait for results. It is already full of patients on hospital beds, pushed two together in three out of the five consultation rooms. Some are elderly, confused, alone. Some are young, injured or very unwell. One is a mental health patient with severe anxiety. This is not the place to make her feel better. Far from it.

Over the PA system, pre-alerts for ambulances carrying critically unwell patients are announced – the ones whose condition is life-threatening. In 11 minutes, four ambulances carrying patients who need immediate resuscitation arrive. This would saturate the system on a good day. Today they have nowhere else to go.


The inadequate care we are providing is the inevitable reality of the government’s funding decisions

I hear a call for “security urgently” over the PA system. The call is repeated two minutes later. We all know it’s for show. The security team are stretched and scattered all over the hospital, and can rarely answer those calls. This time a staff member had been attacked by an intoxicated patient.

As I walk back down the jammed corridor, increasing numbers of screaming and crying patients line the lanes, creating an emotional and physical obstacle course that every staff member walks down. It’s truly sickening.

What’s worse is that this situation was entirely predictable. The inadequate care we are providing is the inevitable reality of the government’s funding decisions. If you strip back funding, force hospitals to make savings they can’t afford, devastate primary and social care, and fail to invest in staffing or resources to match demand, we are forced to tell our patients: “I’m so sorry, we can’t look after you safely today.”

And for many of us, we’re tired of apologising on behalf of the ministers who have made these decisions. It’s just too much. We are too tired to keep trying to smile. We are struggling to try to make it work. We’re sorry we’ve let you down, but we’re broken and we need your help.

The anonymous writer is an A&E doctor who works in a hospital in south-east England

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Almost 100 million people a year ‘forced to choose between food and healthcare’

Almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses.

A report, published by the World Health Organization and the World Bank on Wednesday, found the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $ 1.90 (£1.40) a day.

Researchers found that more than 122 million people around the world are forced to live on $ 3.10 a day, the benchmark for “moderate poverty”, due to healthcare expenditure. Since 2000, this number has increased by 1.5% a year.

A total of 800 million people spend more than 10% of their household budgets on “out-of-pocket” health expenses, defined as costs not covered by insurance. Almost 180 million people spend a quarter or more, a population increasing at a rate of almost 5% per year, with women among those worst affected.

“Only 17% of women in the poorest fifth of households have adequate access to maternal and child health services compared to 74% of women in the richest fifth of households,” said Timothy Evans, senior director of health, nutrition and population at the World Bank Group.

“This remains a problem for not only poor regions of the world, but for all countries at all income levels. At the World Bank, we think that this is both morally and economically bankrupt and unsustainable.

“Universal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.”

The WHO and the World Bank want everyone, irrespective of their circumstances, to receive necessary health services without risking financial hardship.

Though universal health coverage is a key target of the UN sustainable development goals, campaigners argue that without a solid commitment from governments this target is out of reach.

“Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out,” said Oxfam’s health policy adviser, Anna Marriott. “Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves.

“We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich.”

According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.

Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.

The problem of healthcare affordability is not limited to developing countries. In Europe, Latin America and parts of Asia, each of which have high levels of access to health services, increasing numbers of people are spending at least 10% of their household budgets on health expenses.

Almost 100 million people a year ‘forced to choose between food and healthcare’

Almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses.

A report, published by the World Health Organization and the World Bank on Wednesday, found the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $ 1.90 (£1.40) a day.

Researchers found that more than 122 million people around the world are forced to live on $ 3.10 a day, the benchmark for “moderate poverty”, due to healthcare expenditure. Since 2000, this number has increased by 1.5% a year.

A total of 800 million people spend more than 10% of their household budgets on “out-of-pocket” health expenses, defined as costs not covered by insurance. Almost 180 million people spend a quarter or more, a population increasing at a rate of almost 5% per year, with women among those worst affected.

“Only 17% of women in the poorest fifth of households have adequate access to maternal and child health services compared to 74% of women in the richest fifth of households,” said Timothy Evans, senior director of health, nutrition and population at the World Bank Group.

“This remains a problem for not only poor regions of the world, but for all countries at all income levels. At the World Bank, we think that this is both morally and economically bankrupt and unsustainable.

“Universal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.”

The WHO and the World Bank want everyone, irrespective of their circumstances, to receive necessary health services without risking financial hardship.

Though universal health coverage is a key target of the UN sustainable development goals, campaigners argue that without a solid commitment from governments this target is out of reach.

“Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out,” said Oxfam’s health policy adviser, Anna Marriott. “Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves.

“We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich.”

According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.

Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.

The problem of healthcare affordability is not limited to developing countries. In Europe, Latin America and parts of Asia, each of which have high levels of access to health services, increasing numbers of people are spending at least 10% of their household budgets on health expenses.

Almost 100 million people a year ‘forced to choose between food and healthcare’

Almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses.

A report, published by the World Health Organization and the World Bank on Wednesday, found the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $ 1.90 (£1.40) a day.

Researchers found that more than 122 million people around the world are forced to live on $ 3.10 a day, the benchmark for “moderate poverty”, due to healthcare expenditure. Since 2000, this number has increased by 1.8 million a year.

A total of 800 million people spend more than 10% of their household budgets on “out-of-pocket” health expenses, defined as costs not covered by insurance. Almost 180 million people spend a quarter or more, a population increasing at a rate of almost 5% per year, with women among those worst affected.

“Only 17% of women in the poorest fifth of households have adequate access to maternal and child health services compared to 74% of women in the richest fifth of households,” said Timothy Evans, senior director of health, nutrition and population at the World Bank Group.

“This remains a problem for not only poor regions of the world, but for all countries at all income levels. At the World Bank, we think that this is both morally and economically bankrupt and unsustainable.

“Universal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.”

The WHO and the World Bank want everyone, irrespective of their circumstances, to receive necessary health services without risking financial hardship.

Though universal health coverage is a key target of the UN sustainable development goals, campaigners argue that without a solid commitment from governments this target is out of reach.

“Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out,” said Oxfam’s health policy adviser, Anna Marriott. “Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves.

“We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich.”

According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.

Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.

The problem of healthcare affordability is not limited to developing countries. In Europe, Latin America and parts of Asia, each of which have high levels of access to health services, increasing numbers of people are spending at least 10% of their household budgets on health expenses.

Almost 100 million people a year ‘forced to choose between food and healthcare’

Almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses.

A report, published by the World Health Organization and the World Bank on Wednesday, found the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $ 1.90 (£1.40) a day.

Researchers found that more than 122 million people around the world are forced to live on $ 3.10 a day, the benchmark for “moderate poverty”, due to healthcare expenditure. Since 2000, this number has increased by 1.8 million a year.

A total of 800 million people spend more than 10% of their household budgets on “out-of-pocket” health expenses, defined as costs not covered by insurance. Almost 180 million people spend a quarter or more, a population increasing at a rate of almost 5% per year, with women among those worst affected.

“Only 17% of women in the poorest fifth of households have adequate access to maternal and child health services compared to 74% of women in the richest fifth of households,” said Timothy Evans, senior director of health, nutrition and population at the World Bank Group.

“This remains a problem for not only poor regions of the world, but for all countries at all income levels. At the World Bank, we think that this is both morally and economically bankrupt and unsustainable.

“Universal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.”

The WHO and the World Bank want everyone, irrespective of their circumstances, to receive necessary health services without risking financial hardship.

Though universal health coverage is a key target of the UN sustainable development goals, campaigners argue that without a solid commitment from governments this target is out of reach.

“Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out,” said Oxfam’s health policy adviser, Anna Marriott. “Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves.

“We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich.”

According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.

Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.

The problem of healthcare affordability is not limited to developing countries. In Europe, Latin America and parts of Asia, each of which have high levels of access to health services, increasing numbers of people are spending at least 10% of their household budgets on health expenses.

Almost 100 million people a year ‘forced to choose between food and healthcare’

Almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses.

A report, published by the World Health Organization and the World Bank on Wednesday, found the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $ 1.90 (£1.40) a day.

Researchers found that more than 122 million people around the world are forced to live on $ 3.10 a day, the benchmark for “moderate poverty”, due to healthcare expenditure. Since 2000, this number has increased by 1.8 million a year.

A total of 800 million people spend more than 10% of their household budgets on “out-of-pocket” health expenses, defined as costs not covered by insurance. Almost 180 million people spend a quarter or more, a population increasing at a rate of almost 5% per year, with women among those worst affected.

“Only 17% of women in the poorest fifth of households have adequate access to maternal and child health services compared to 74% of women in the richest fifth of households,” said Timothy Evans, senior director of health, nutrition and population at the World Bank Group.

“This remains a problem for not only poor regions of the world, but for all countries at all income levels. At the World Bank, we think that this is both morally and economically bankrupt and unsustainable.

“Universal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.”

The WHO and the World Bank want everyone, irrespective of their circumstances, to receive necessary health services without risking financial hardship.

Though universal health coverage is a key target of the UN sustainable development goals, campaigners argue that without a solid commitment from governments this target is out of reach.

“Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out,” said Oxfam’s health policy adviser, Anna Marriott. “Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves.

“We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich.”

According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.

Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.

The problem of healthcare affordability is not limited to developing countries. In Europe, Latin America and parts of Asia, each of which have high levels of access to health services, increasing numbers of people are spending at least 10% of their household budgets on health expenses.

Almost 100 million people a year ‘forced to choose between food and healthcare’

Almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses.

A report, published by the World Health Organization and the World Bank on Wednesday, found the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $ 1.90 (£1.40) a day.

Researchers found that more than 122 million people around the world are forced to live on $ 3.10 a day, the benchmark for “moderate poverty”, due to healthcare expenditure. Since 2000, this number has increased by 1.8 million a year.

A total of 800 million people spend more than 10% of their household budgets on “out-of-pocket” health expenses, defined as costs not covered by insurance. Almost 180 million people spend a quarter or more, a population increasing at a rate of almost 5% per year, with women among those worst affected.

“Only 17% of women in the poorest fifth of households have adequate access to maternal and child health services compared to 74% of women in the richest fifth of households,” said Timothy Evans, senior director of health, nutrition and population at the World Bank Group.

“This remains a problem for not only poor regions of the world, but for all countries at all income levels. At the World Bank, we think that this is both morally and economically bankrupt and unsustainable.

“Universal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.”

The WHO and the World Bank want everyone, irrespective of their circumstances, to receive necessary health services without risking financial hardship.

Though universal health coverage is a key target of the UN sustainable development goals, campaigners argue that without a solid commitment from governments this target is out of reach.

“Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out,” said Oxfam’s health policy adviser, Anna Marriott. “Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves.

“We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich.”

According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.

Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.

The problem of healthcare affordability is not limited to developing countries. In Europe, Latin America and parts of Asia, each of which have high levels of access to health services, increasing numbers of people are spending at least 10% of their household budgets on health expenses.

Residents of blocks next to Grenfell Tower fear being forced to move back

Residents of three blocks next to Grenfell Tower who are living in temporary accommodation fear that they will be forced to return when the estate is refurbished even though many have traumatic memories of the deadly fire.

There is concern among the 161 households from the so-called walkway blocks that new council rehousing guidelines mean they will face a series of restrictions and less secure tenancy terms if they move elsewhere.

Community leaders have accused Kensington and Chelsea council of breaking promises to residents of the Grenfell Tower estate as a result.

A spokesman from North Kensington Law Centre, which has worked closely with many Grenfell families, said they were “deeply concerned about the policy in its current form”.

He said: “Walkways residents will be faced with a difficult choice as to whether they forgo their housing security and some vital tenancy rights or face the trauma of having to return to the estate in the shadow of Grenfell.

“This policy runs the serious risk of failing to address residents’ needs, pressurising them into returning to the estate, potentially at the cost of their wellbeing and that of their children.”

Those who lived in the main tower, where at least 80 people died, and another badly-damaged block, Grenfell Walk, were told soon after the blaze that there would be no restrictions on their opportunities to choose a new council home.

However, people in the three walkway blocks adjoining the main tower – Barandon Walk, Hurstway Walk and Testerton Walk – have had to wait more than four months for news of their options.

A draft rehousing plan for the walkways, published before a council committee meeting on Monday night, says those wishing to move will only be given two chances to accept offers of new homes. If they refuse both, they will lose any priority.

It stipulates that walkway residents will be given a maximum of 900 “points” for the council’s housing list, not enough to automatically place them at the top for other homes. Tenant rehoused by a housing association or another council will not necessarily keep the same security of tenure, thus potentially losing a lifetime lease.

Jennifer Nadel, who stood for the Green party in Kensington in the June election and has worked as a volunteer supporting Grenfell survivors, said it was “utterly inhumane” to penalise the residents.

She said: “It puts tenants in the position of having to choose between their mental and emotional health and their housing rights. Yet again, the council has failed to respond with humanity to this tragedy.”

John Healey, the shadow housing minister, said: “Ministers promised they would do everything they can to support the victims of the Grenfell Tower fire. That must include making sure that any residents affected by the fire do not lose out as a result of being rehoused.”

One community leader who has worked with many walkway families said the policy of giving residents just two choices of new homes seemed especially onerous: “Who’s going to monitor if they’ve been given appropriate choices? What if they’re offered a flat on a high floor of a tower block?”

One resident, who asked not to be named, said it was hard to overstate the emotional impact of returning to the estate: “Out of one window you have the investigations team and on the other side you have the tower. And then there’s the emotional impact of the night.”

The resident said the rehousing policy failed to address the needs of locals who might wish to eventually return home, but only once the fire-ravaged tower was covered up or removed.

“For me, the biggest problem is that it pressures people to move back and stipulates what happens if you move away. What it doesn’t say properly is what happens to people who want to move back but not yet.”

Kim Taylor-Smith, the Kensington and Chelsea councillor who leads on housing, said the council would be consulting residents: “It is going through a thorough serious consultation – starting with scrutiny from the public this very evening … [the council] understands that many of these people will also be severely traumatised by what they saw that night”.

“We believe that we have put forward a fair way to help people out of hotels and either back into their own homes, into temporary accommodation, or into a home in a different location.”

Hospital bosses forced to chant ‘we can do this’ over A&E targets

Hospital bosses were forced to chant “we can do this” by a senior NHS official in an effort to improve their accident and emergency performance in advance of what doctors have warned will be a tough winter for the NHS.

Hospital trust chief executives say they were left feeling “bullied, patronised and humiliated” by the incident last week at a meeting attended by Jeremy Hunt, the health secretary, and Simon Stevens, the head of the NHS in England.

The leaders of about 60 trusts which NHS national bodies deemed to have the worst record on meeting the politically important four-hour A&E treatment target were called into a meeting held in London on Monday 18 September.

Chief executives present say that they were divided into four regional groups, covering the south and north of England, London, and the Midlands and east of the country, each of which held a separate session with a senior NHS England official.

Paul Watson, NHS England’s regional director for the Midlands and east of England, then encouraged those in the group he was leading to chant “we can do it” as part of a renewed effort to improve their A&E performance. Hunt and Stevens are not thought to have been at that session; nor was Jim Mackie, chief executive of health service regulator NHS Improvement, who jointly convened the meeting with Hunt and Stevens.

One chief executive said: “It was awful – the worst meeting I’ve been at in my entire career. Watson said: ‘Do you want the 40-slide version of our message or the four-word version?’ Everyone wanted the four-word version, obviously.

“He then said ‘I want you to all chant ‘we…can…do…this’. It was awful, patronising and unhelpful, and came straight after the whole group had just been shouted at over A&E target performance and told that we were all failing and putting patient safety at risk.”

According to the Health Service Journal, which revealed what had happened at the meeting, Watson told trust bosses that they were initially chanting too quietly and that they should chant the slogan again but louder, and “take the roof off” with the noise.

Watson’s use of the tactic has prompted complaints from within the NHS that the chanting was “Bob the Builder for NHS leaders”, after the children’s TV character Bob the Builder with his “Can we fix this? Yes we can” catchphrase. Another HSJ reader posted a comment on its website saying: “More akin to North Korea than the NHS”.

Anger and ridicule directed at Watson have prompted him to apologise for and explain his behaviour in messages he posted on the HSJ website since it published the story.

“If anyone found my session on Monday inappropriate in any way then I can only apologise – it was meant as light relief rather than brainwashing,” said Watson.

“As I said at Monday’s event, this can be done. If that seems cheesy or patronising then so be it but it does have the merit of being true – Paul”, he added.

He also repeated his claim that inadequate A&E performance endangered patients’ safety.

“It’s good to let off steam but let’s remember what’s at stake here: 1 Urgent care is the most basic service the NHS provides; 2 A badly run, crowded ED [emergency department] is a miserable experience for our patients; 3 These patients are often frail, elderly and frightened as well as very ill; 4 A crowded ED can be dangerous.”

If other trusts could provide excellent A&E services despite the rising demand for care, why could the 60 represented at the meeting not do that, he asked. He also angered trust bosses by saying that “the biggest single determinant of whether a struggling service is turned round is the confidence, optimism and determination of local leadership to do this and follow it through”.

The Guardian has approached NHS England and the Department of Health for comment.