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Emergency services are in need of intensive care


Dr Shaba Nabi


The NHS has never had a great track record for elective care, with outpatient waits exceeding 12 months even before pandemic times. But it has never failed to deliver access to urgent care, and we could all sleep safely in the knowledge we’d have timely access to an ambulance, a cardiac stent or emergency surgery. 

The experience of recent months suggests this is no longer the case and I have never been more scared for the health and wellbeing of my loved ones. 

Perhaps the most tragic and public example was the management of our very own Dr Kailash Chand. His son published his view that paramedic delays had contributed to his father’s recent death – a difficult, but not surprising read. 

I have experienced similar ambulance delays, personally and professionally. In July, I managed two patients in my practice who needed emergency admission after collapsing in the waiting room with chest pains. After waiting three hours for a blue light ambulance, I made the decision to advise they travel to hospital in a car. 

That same week, as I was driving home from work on a Friday evening, I saw an elderly man lying bleeding on the pavement. Because he was alert, awake and breathing, my immediate thought as I went to help was ‘this man’s not getting an ambulance for love nor money’ – despite his obvious need for one. I spoke to ambulance control who confirmed my fears and advised me to call 111. When I questioned how a lone GP would have the ability to ‘scoop and dispatch’, they had no answer. 

As it was past 8pm and the poor man was shivering I decided to call my husband, who helped me lift the man into my car and take him home. I offered basic wound care for his head, heavily safety netted him and went round the next morning to check he was okay. 

This incident really shook me to the core as I knew the man could have been lying on the side of the road for hours, waiting for help to arrive. I reflected on a society that accepted this situation for its most vulnerable but put my concerns down to a bad week for emergency care demand.

But a recent consultation with a patient confirmed that the crisis week was turning into a crisis month, which was morphing into a crisis season. The patient’s husband had sustained a fall three weeks earlier that resulted in a fractured neck of femur. He was waiting for an ambulance for eight hours – confused and in pain. Despite trying to compose myself, I was unable to stop my voice cracking with emotion as his wife recounted this. 

Not only is there an obvious workload issue for GPs managing these emergency situations in the community, there is significant moral injury associated with these situations. Yet all I see in the media is a portrayal of how lazy and incompetent I am because I am not seeing patients face to face.

GPs are the convenient scapegoats the media choose to spotlight to avoid exposure of an NHS in crisis – an NHS that is going down in flames. 

Dr Shaba Nabi is a GP trainer in Bristol. Read more of Dr Nabi’s blogs at pulsetoday.co.uk/nabi

READERS' COMMENTS [2]

Patrufini Duffy 4 October, 2021 6:33 pm

Cracks are everywhere and sadly it is the front-line helping cover up the Government for the sake of goodwill. They bleed your altruism dry and play on your heartstrings to “do the best” for the public, whilst they categorically cause system failures and suffering. They brainwashed you very early on, through consultation models and the noble gatekeeper role. Now they’ve switched your keys, and made the gate into a rabbit hole, which circles and ends up on your desk. You’re not even owed a Consultant branding, just a plain GP. Who sees everything, now, including AE and surgical problems. The BBC saliently picked an endometriosis patient who lambasted GPs on Thursday. For her chronic gynaecological and surgical condition. Wasn’t it the GP who helped her initially? Or did she just walk into the hospital and get her diagnosis off the cuff, same day at 10.20am after walking the dog and a trip to Starbucks, after DNAing her last 2 appointments. People for example, have RTAs, sports injuries, falls, chest pain, collapse, bleeding and eye issues and STILL call you. They avoid opticians, dentists, psychologists and yes AE and even an ambulance…with “can you call them for me?”. Even when their child is “getting worse”, they call you. Never doing the right thing, just bleeding you instead for your magical “useless GP” wand. But, they come with their double edged sword, and for you to check your CQC regulated service specification, indemnity and your own ideas of the GMC and your need to “stay within your competencies”. Medicine has become a bottomless sinkhole, everyone’s passing the buck, from 111 to midwives to health visitors and Consultants – because compassion fatigue is now ubiquitous and leadership broke this system and dished out disharmony, hate and bitterness into the gutter, which what is in essence a pure and noble science, not some joke and trivial chirard. The wheat obscures the chaff, and when the chaff is seen you gulp with dismay. Here’s to the Americans, disintegration and fragmentation.

Cameron Wilson 4 October, 2021 9:24 pm

Very true PD, suspect UK Plc as a lot of the public have known, and taken for granted, is going to get a very expensive wake up call. Just have to hope the sacrificial lambs escape the dangerous end game!