What is expected and available on the NHS in UK?

A questionable practice at this A&E hospital is that every patient is inserted with a spatula into their elbow vein to test blood samples and this procedure is not removed but remains attached in their arm, until they are discharged from the hospital.

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A doctor conducts a blood test on a female patient in King’s Cross, London. A survey has found that one in five surgeries in the capital may close in three years. Photograph: Alamy

With 8 to 10 hours of intermittent sunshine and weather as warm as Sri Lanka, over the past ten days, nobody in their right senses is wanting to visit A&E (Accident & Emergency Dept.) of any hospital, for even urgent healthcare or for emergency treatment, due to weather weariness and the prevailing excessive waiting time for treatment. They rather be on the beach instead?

What is available on the NHS? 

As we reflect after nearly two years of the pandemic, with Doctor’s surgeries and family practices restricted, patients however, have become more and more reliant on the Accident & Emergency (A&E) service centres at local hospitals. Health Care professionals never contemplated the A&E, as an alternative health service to GP Surgeries. But, it seems to have become the preferred option. A&E’s in their turn are seeking unscrupulous coping practices? 

Although the Government has pumped in money to A&E’s, with recent dramatic increases in resources available to NHS A&E departments in local hospitals, due to demand, management is lacking. Whilst this has involved reorganisation of hospital facilities, a noticeable redeployment of A&E existing staff, to bring in recently retired and newly graduated medics, meeting demand and noticeable security personnel to calm unruly behaviour, not much is on show.

Sadly, this increase in demand and change to supply of General Practice (GP) Surgeries has had a knock-on effect on care provided for patients visiting A&E in local hospitals, for not only urgent health care delivery, practices seem outdated. 

Coronavirus created a sign of patients wanting to postpone or decide against seeking treatment with GP Surgeries, potentially storing up health problems for A&E attendance. 

Older people were seen to be the keen users of A&E than younger people. Put another way, according to statistics there were 117 and 114 elective admissions per 1000 for those in their 70’s and 80’s respectively, but just 25 for every 1000 people in their 30’s. Taking this into account, it suggests that potential disruptions to emergency care will disproportionately impact older people and those who are the least affluent. 

Source of problem

Staff shortages, both doctors, nurses and medical test care professionals in the A&E, is largely seen as the main cause, in fact leading to a minimum of 6 to as much as  10 hours of tiresome waiting time to obtain most treatment. 

A case in point is noted in one A& E Department at a hospital at Whitechapel, East London. It serves the densest populated Bangladeshi community in London. The current practice is for a Triad Nurse to first screen a patient after arrival/registration; to be seen by a young doctor within 5 hours waiting time, and for tests such as ECG and Blood tests which supposedly takes a further two hours for results to be obtained. At this stage it is for a Consultant doctor to make a decision whether to order a second or duplicate test, on each patient.

Additional waiting time at A&E is agonising?

On the pretext that the ECG and Blood tests are imperative, as standard procedure for assessment of every A&E patient in attendance at this East London Hospital, irrespective of their medical condition and/or complaint and in the event the tests are found to be in-conclusive, it has become mandatory to keep all patients waiting for duplicate Blood tests and for their results, however long it takes? 

A questionable practice at this A&E hospital, is that every patient is inserted with a spatula into their elbow vein to test blood samples and this procedure is not removed but remains attached in their arm, until they are discharged from the hospital.

Patients are to fend for themselves to keep the inserted “spatula” intact, as a means of enabling further Blood tests to be taken, if necessary, keeping all patients obligated, with or without consent, to remain in the A&E department. It seems a fool proof, time reduced system for the hospital, but the opposite for a tired patient? 

The observation during a visit to this hospital was that it was a compulsory procedural wait in the hospital of at least 10 hours, without patient consent or reasonable explanation? It was further observed, that every patient was given the same reason that their Blood test was not conclusive and were coerced to give a second Blood sample for no explained reason?  This was a standard medical practice at this hospital? But, the patient, had to accept it, as the “spatula” remained implanted in their elbow vein. 

On further investigation, it was ascertained that the first blood test sample from each of the waiting patients was lost, in the laboratory, requiring a second sample of blood?

Complaints of unscrupulous practice of keeping patients inside Hospital A&E departments awaiting prolonged results, by extending waiting times in A&E, has been raised by patients, with Hospital Management Authorities, 

The twin issues for early resolution is alleviation of staff shortage, both doctors and for adequate and qualified staff in Medical Test Centres, able to cope with the demand and not come out with frivolous excuses, to forcibly keep patients in A&E departments, over unduly long waiting times when tiredness can cause more misery? 

Victor Cherubim

Victor Cherubim is a London-based writer and a frequent columnist of the Sri Lanka Guardian

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