Opinion: ‘Hospitals at home’ plan should not prevent more doctors being trained

Extraordinarily too, just days ago, the Government has threatened medical schools, that unless they limit the number of medical school places this year, they will be subject to fines this threat coming at a time when the NHS, including our own NHS here in Sheffield, is drastically short staffed. These threats are even contrary to the Government’s own 2022/23 priorities and operational planning guidance in which they say they are aiming to grow the workforce.

On the heel of the above threat, has also come, the further announcement in recent days, of the Government plan for thousands of patients to be cared for by video link, in a ‘hospital at homes’ initiative, to ease pressure on the NHS and in particular pressure on A&E wards, whom too have a crisis relating to shortage of beds.

Vulnerable communities have been noting that what is now happening, was mapped out ahead, in the 2019 ‘NHSLongTermPlan ‘. Now four years later, aspects of this plan are being rolled out as being the ‘ Urgent & Emergency Care Recovery Plan.’ under terms of ‘ hospitals at home’.

Older people and vulnerable people are targeted to be recipients of this service, in particular, which Government say, is based on recent trials where virtual consultations took place in different parts of England. This trial included consultations over the internet but some cases had a paramedic and community nurse in attendance in the patients’ homes. The findings from the trial, they say, show a decrease in hospital admissions , which was, let’s face it, the intended action in the first place, given the shortage of beds and the fact the trial was trialling ‘hospitals at home‘.

The trial was initiated following warnings from senior officials that hospitals are in crisis with wards full of patients who would be better treated elsewhere, fuelling excessively long waiting times in A & E and hospitals being unable to admit patients.

Under resourcing and under provision in hospitals has been allowed to grow from 2019 and has meant that in December alone, 55,000 faced trolley waits of at least 12 hours in A&E, with the average wait for an ambulance for people experiencing heart attacks and strokes, reaching 93 minutes, which was more than twice the figure of 43 minutes for the previous month.

Influencing this too, is the fact that care in the community, is also in crisis and chronically underfunded, resulting in sizeable numbers of older people and vulnerable people, whom having been treated successfully and well enough to go home , are unable to vacate hospital beds because of the Government’s failings to invest in and properly resource community care and the social care sector also.

A prevailing concern for many, is the potential of privatisation by stealth to occur in regard to the above initiative and other planned for but not yet launched initiatives, to come.

As Government have said, out National Health Service was founded in 1948 in place of fear - the fear that many people had of being unable to afford care for themselves and their families. And it was founded in a spirit of optimism and compassion - at a time of great uncertainty, coming shortly after the sacrifices of war. At its best our National Health Service is the practical expression of a shared commitment by the British people: over the past seven plus decades, and should be there when we need it, at the most profound moments in our lives.

Whilst welcoming the need for hospital admissions, to be reduced, all of the above initiatives and diminutions do not come without risks to the general public and particularly to our older and vulnerable populations who are already subject to far to many health inequalities. Nor should it be an either or situation, that sees resources deployed to these ‘virtual wards’ / ‘home hospitals’, to the detriment of medical schools being allowed to train urgently needed doctors and dentists and other professionals, required to alleviate the under-staffing in the NHS, nor should it stop Government increasing the numbers of beds in hospitals and nor should resources be redeployed either away from the seven million people, whom today are on waiting lists for hospital treatment.