NHS, what's the plan?

Letter sent to my NHS trust, asking for them to be accountable for the treatment of patients in my constituency.

Dear Paul Scott, CEO

I am writing to you to demand that the key issues affecting the treatment of patients are addressed so that the government do not use the NHS as an excuse to call for further damaging restrictions such as lockdown, mandatory masks, and limited visiting to patients in hospitals. The restrictions imposed in the last two years have had a devasting impact on patients access to health care, the mental and physical health of millions and the economy and that cannot be allowed to happen again.

There are five key areas that must be addressed immediately

Staffing levels

A report submitted to the Health and Social Care Committee by the Nuffield Trust dated 25 July 2022¹ showed damning evidence of understaffing with vacancies for 38,972 nurses and 8,016 doctors, however real figures could be as high as 50,000 and 12,000 respectively. Overall, as of March 2022, there were 105,855 posts (7.9%) not filled with permanent or fixed terms staff and an estimated sickness absence rate of 6.0%. This is having a serious and detrimental impact on patient care and patient safety. We need more nurses and doctors to ensure that patients are treated safely and quickly.

What are your plans to reduce the sickness absence rate and fill the vacancies for doctors and nurses ahead of winter when admissions may increase?

Bed Capacity

According to the Kings Fund, the total number of beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20 with General and Acute beds falling by 44%, while the number of patients requiring treatment has significantly increased. The UK has fewer acute beds overall and fewer separate rooms within wards relative to the population size compared to other health systems. NHS England stats show that in March 2020 bed capacity reduced by a further 10% as a result of lockdowns and infection control measures. Only in the last quarter have those number recovered to pre-2020 levels but consequently thousands of patients were not treated. This is unacceptable as patients have suffered. The NHS in England should be actively ensuring we have enough beds to meet demand.

In addition, almost 700,000 people waited over 12 hours in A&E up to July 2022. NHS England has seen an increase of 144% in monthly 12 hour waits since 2019. The longer waits are driven by an acute shortage of beds, staff, and available social care places. It is estimated that the long waits may contribute to an increased mortality rate in A&E departments each month. Lives are being put at risk because of lack of planning and investment.

Do you have a plan in place to increase the number of general and acute beds available now, over the next six months and a longer-term plan to ensure sufficient beds?

Waiting lists for operations

There are currently 6.6 million people on NHS waiting list (as of May 2022) which is 56% higher than in 2020. The number waiting more than a year stands at 331,623 and 57,762 waiting in excess of 18 months. A recent survey by the Private Healthcare Information Network has found that there were 69,000 self-funded treatments in the UK in the final three months of last year - a 39% rise on the same period before the 2020. The lockdowns and restrictions led to huge number of patients due to have elective surgery in 2020 and 2021, waiting much longer resulting in worsening health conditions, increase in disease severity in many cases death. We should not be forced to pay for private healthcare when we already pay taxes for a service that most of us have had no access to for over two years. The NHS in England must tackle the waiting lists immediately.

What plans does the trust have in place to tackle the current waiting list and clear the back logs?  

What is the long-term plan to ensure waiting lists remain low so that patients are reassured they will be treated quickly?

Impact of lockdowns, masks and restrictions on visiting patients

There is overwhelming evidence to show that lockdowns caused more harm to the population of England than any perceived benefits. Denying access to healthcare to millions of patients was a catastrophic decision leading to some of the issues I have mentioned above including late or missing diagnosis of serious and life-threatening diseases and easily treatable diseases and ongoing chronic conditions were made worse and harder to treat. There is no conclusive evidence that wearing masks for patients, visitors and non-clinical staff reduces the spread of any respiratory virus and yet thousands of NHS staff and visitors are forced to do so causing inconvenience, anxiety and health problems. The flimsy blue masks are not by design made to prevent the spread of diseases, yet millions of mass-produced blue masks are distributed by the NHS to staff and patients at a significant cost to the taxpayer and the environment. The initial decision to stop all visiting had a hugely detrimental impact on patient wellbeing and the subsequent restriction on visitors causes stress at an already difficult time. It is well documented that having visitors whilst in hospital has a positive impact on a patient’s overall mental and emotional wellbeing and helps recovery.

Please provide clear clinical and scientific evidence to support the decision to force NHS staff to wear masks in order to reduce the spread of respiratory viruses and the results of any impact assessment carried out at your trust that considered the impact on staff and their physical and mental health? 

Please provide evidence that the restriction on the number of visitors has reduced the spread of a respiratory virus and details of consultations carried out with patients to assess the impact on their wellbeing?

PCR testing for COVID-19

PCR testing of staff routinely and of inpatients who may not have any notable symptoms gives a very distorted picture of the prevalence of covid-19. These statistics are frequently used to instil fear that COVID-19 is a still a threat to justify draconian restriction, even though the disease is now endemic and has an IFR similar to Influenza. If we did not test for Influenza and publish daily figures, we should not be doing so for COVID-19 as there are no benefits.

Why are staff and patients still being tested with PCR tests? What is the plan to phase out PCR testing and to rely on actual clinical diagnosis on patients and staff with symptoms?

As a member and representative of the public, I will not tolerate any more restrictions that impact my access to healthcare or that affect my family. I will not accept that my taxes are used to fund the NHS when there are significant backlogs, money spent on pointless PCR testing, masks, when patients cannot see doctors face to face and are not being diagnosed and treated. The government cleared the debts of all NHS trusts in May 2020 and all trusts then received billions in Covid budgets. Despite that we face an NHS crisis and that is not being addressed adequately.

I would like clear and detailed responses to all of the questions above.

Yours sincerely,

Joel Smalley

Official spokesperson for Reform UK, Saffron Walden

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If you are UK resident, you can help by sending a copy of this letter to your local NHS Trust. Contact me for details.

1. https://committees.parliament.uk/writtenevidence/109670/pdf/