Elderly face ‘new normal’ of NHS corridor care and long waits

Elderly people face a “new normal” of corridor care and long waits in hospitals as the threat of another six months of strike action by junior doctors looms.

The head of Age UK said that vulnerable people are already having operations postponed on multiple occasions after more than a year of industrial action, with the pay dispute between NHS staff and ministers showing no sign of ending.

On Friday, the British Medical Association (BMA) revealed almost two-thirds (62 per cent) of speciality doctors in England voted against the Government’s latest pay offer with the union now set to consult members on the next steps.

The junior doctors’ mandate also ended on Friday. The reballot, which is open until 20 March and expected to end in a majority supporting further walkouts, would run until 20 September if secured.

The consultants’ mandate for strike action runs out on 18 June leaving the possibility that all three groups of doctors could strike simultaneously from next month.

Industrial action since the end of December 2022 has already cost the NHS around £3bn and more than 1.4 million appointments have had to be rearranged right across hospital, mental health and community services.

Health leaders told i that the disruption has gone on for so long that the elderly and those waiting for vital scans in particular now expect lengthy delays and poorer care as standard.

Caroline Abrahams, Charity Director at Age UK, said: “Sadly, we know that today, many older people are stuck on lengthy waiting lists for treatment and diagnostics, and meanwhile are coping with serious health conditions that cause them pain and discomfort and interfere with them living a full life.

“These waiting lists were too long before Covid-19 arrived but the pandemic made them a lot worse. This is the already difficult context against which the news of any potential future industrial action by health professionals will be received by older people and their families, and it’s the last thing they will want to hear.

Junior doctors participate in a picket line at St Thomas’ Hospital on January 3, 2024 in London, England. (Photo: Guy Smallman/Getty Images)

“Unfortunately, the impact of industrial action tends to be cumulative, and we certainly know of some older people whose appointments have been postponed on several occasions, further elongating their already lengthy waits.

“For the sake of our older population we must not sleepwalk into a situation in which ongoing industrial action by health professionals is treated with something of a shrug by policymakers and viewed as ‘the new normal’.

“All the parties have a responsibility to come to the table and make an agreement to bring an end to the disrupted healthcare that older patients are experiencing.”

A recent study led by the University of Warwick in collaboration with the Society for Acute Medicine (SAM), found that younger patients with less complicated conditions are waiting a shorter time for assessments than older and frailer patients with complex care needs.

The authors suggested this is largely due to the national drive to prioritise same day emergency care (SDEC), which involves providing urgent care in hospital without the need for admission to a ward which can lead to the prioritisation of patients with simpler needs who can be treated and discharged more quickly.

Dr Tim Cooksley, immediate past president of SAM, said colleagues have “tremendous empathy” with junior doctors due to the “challenging working conditions that permeate throughout the NHS currently alongside their significant pay erosion”.

He said: “They have every right to feel aggrieved and it is entirely understandable that they do. Unfortunately, industrial action adds to the multitude of problems affecting the NHS which are a result of a failure to tackle the root causes over the past 10 years.

“It is imperative that a resolution to the current dispute is reached urgently and we continue to call for this because, as we have warned previously, there is an increasing sense of tragic inevitability that strikes are becoming ‘business as usual’.

“This would be a disaster and an impossible impediment to overcome for NHS recovery so, as each period passes by, it becomes even more important the government prioritises an agreement.”

An “insufficient workforce” and lack of capacity to meet demand, combined with “no resilience to cope with any excess strain” was the key cause of the NHS’s problems, not strike action, Dr Cooksley said.

“The result is overcrowded hospitals with insufficient capacity leading to prolonged waits with degrading corridor care and delays in ambulance responses,” he added.

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Junior doctors, who make up around half of all doctors in the NHS, are campaigning for a pay restoration to 2008/9 levels – equivalent to a 35.3 per cent increase. The Government has said that is unrealistic and unaffordable. Last September, it awarded junior doctors a pay rise of 8.8 per cent on average, backdated to April, while consultants received a 6 per cent rise.

In January, consultants rejected an improved pay offer of up to 13 per cent more by the narrowest of margins after 51 per cent voted against it, with a 65 per cent turnout. The BMA urged ministers to better the deal.

Union leaders have said their door “remains open” but no formal talks are ongoing. Last month, junior doctors went on a five-day strike – their 10th round of industrial action – after pay talks broke down again.

Rachel Power, Chief Executive of the Patients Association, called for both sides in this dispute to do “whatever it takes” to keep negotiations open.

She said: “Progress requires openness, pragmatism and commitment to constructive dialogue from Government officials and union leaders alike.

“We ask them to seek common ground so a deal can still be struck. All parties must remain at the table for as long as it takes to protect patients from the continued impact of strikes. Patients struggling to access timely care must not go unheard.”

This week, the Institute for Fiscal Studies (IFS) warned that although waiting lists are falling they will stay above pre-Covid levels until 2030. The report also said the length of time patients must wait for A&E care, diagnostic tests, cancer care and surgery will remain high for the rest of the decade.

Sir Julian Hartley, chief executive of NHS Providers, said: “We just can’t go on like this. There’s still the possibility of further action by senior doctors while doctors in training are being asked if they want to keep striking until the end of September. The impact of walkouts can’t be overstated. They distract trusts’ focus from priorities in order to manage safety in strike-hit services, they hit staff morale and they disrupt patients.”

Sir Julian said that instead of bringing in Minimum Service Level laws in hospitals, which would provide the option for NHS employers to issue work notices to staff, obliging them to work during strike action, ministers should instead “pull every lever possible” to bring the dispute to an end.

“Trust leaders and their teams want to get on with the job of improving services, tackling waiting lists and giving patients first-class care rather than spending too much of their time and energy having to plan for and deal with more strikes,” he said.

The Department for Health and Social Care has been approached for comment.