Editorial
Let’s be honest – the past few months have been tough for anyone working at the hospital coalface. Even the most optimistic masters of NHS spin will have had difficulty denying some of the harsh realities which have faced staff, and patients; often on a daily basis. The Royal College of Physicians’ report Hospitals on the Edge, published last September, presented a gloomy picture of a system on the brink of collapse, becoming overwhelmed by year-round demands which continue to grow inexorably. Then came winter, Norovirus – and Robert Francis. His much anticipated, and long-delayed, report with its 293 recommendations, should be seen as a wake-up call to those in the position to effect change. The political, and media focus so far has been on the failures to recognise what went wrong – target culture, whistleblowing and regulation, as well as individual failings. All of these need to change, but the root causes of the problem should also not be forgotten. I have no doubt that many healthcare workers and patients reading the report from across the UK will have had days, and experiences which were not dissimilar to many of those described in Mid Staffs. The demands on our service, and the expectations of its users is rising; and yet we cannot expand our capacity to meet these demands. The past decade has seen countless efforts to improve efficiency and flow at the hospital front door: admission prevention schemes, ambulatory care, community geriatric services, chest pain pathways and rapid access clinics, to name but a few, have squeezed down the length of hospital stay for many patients. Undoubtedly there is more that can be done; systems can still be improved, but the hamster wheel needs to turn faster and faster each year – and the hamster is getting tired.