Frontline worker's anger at struggling health services

The Leader reported last week on the anger of a Flintshire County Councillor after she heard almost daily "horror stories" from residents about hospitals being 'overwhelmed' and ambulances being tied up on car parks.

And in recent days we have reported on the significant number of emergency vehicles queueing outside the Wrexham Maelor Hospital.

Health service is "a s*** show"
 

A frontline worker - who does not wish to be named - has spoken of first-hand frustrations after encountering the severe pressures arising from these difficulties.

They told the Leader: "I've always known there have been issues and to be honest, I'm fed up.

"Patients and members of the public - in particular Wrexham and Flintshire residents - are suffering, and it's silly.

"I went past the Maelor one night and the ambulances were queuing up the road, and then I drove past the Countess of Chester that night and there were none.

"The health service here is struggling, but a hospital less than 15 miles away is performing much better - why is that?

The health worker took these pictures showing the difference between Wrexham Maelor Hospital (top) and the Countess of Chester on the same night (Image: UGC)"Why is this so poor in Wales compared to England?

"Everyone is doing their best - including A&E staff, but unfortunately they are p***ing in the wind.

"It is the flow through the hospital causing issues. There are so many medically fit patients who are ready for discharge, but there is no onward care in place for them.

"They might need care in the community which could take a number of weeks to arrange, or a nursing home which could take months.

"Until there is somewhere for them to go, they are bed blocking.

"Betsi is not performing and senior management won't admit there is a problem.

"Everyone is fed up and people are genuinely dreading going to work.

"It's an absolute s*** show."

Doctors feel "terrible" because they can't help patients

Wrexham GP Dr Peter Saul said he too has encountered the knock-on effects of the overwhelmed hospital services, particularly in Wrexham.

He explained: "I work for Health Education in Wales and we visited the Maelor fairly recently.

"Staff there were complaining that there are serious pressures making work very difficult.

"Talking about Wrexham now, the physical space available in the department is limited and they have difficulty getting patients out of A&E and into the hospital because there aren't enough beds - and that is because it's difficult to discharge patients due to a lack of community care.

Dr Peter Saul (Image: Dr Saul)"For people like me, what do you do when you go and visit a patient at home, they live alone and need to go to hospital - and you're told an ambulance is going to take six to eight hours to arrive.

"You feel terrible, but you have to leave them to go and see other patients.

"It is not a nice environment. You want to do your best for patients and it makes you feel bad and ask; should I carry on with this?

"And I have never, in my 40 years as a clinician, seen the NHS as bad as it is now.

"I think it's not just BCUHB, it's elsewhere too because we have not invested in our health service expenditure as much as we should have. That's why we're in the position we are at the moment and it's being made worse by an uptick in covid and respiratory infections.

"The other thing that is happening is people are building fences around themselves - so as a GP it's harder now to refer people into hospital than it used to be.

"A lot of departments now put all of these checklists in place before they will accept patients and some of it is absolutely bonkers.

"For example patients who clearly have a strong suspicion of cancer not being accepted because the t's haven't been crossed and the i's dotted - but they're doing it because they're overwhelmed."

Dr Saul concluded that there are "no quick answers" to the problem, adding: "It's probably not just about money, but working better and differently, having better resources to treat people at home and investing more in social care and community health services.

"If someone were to say to me Pete, we're going to make you health minister, I'd say thanks very much but no thanks."
 
 

Help to reshape North Wales healthcare
 

Geoff Ryall-Harvey, regional director for north Wales at Llais (which replaced the North Wales Community Health Council last year), encouraged people who have had difficult experiences in their healthcare to contact his organisation.

"We can take that up as a complaint for them which is a good thing to do," he explained.

"If the health board doesn't have these experiences and concerns, there's not a lot they can do.

"And if they don't want to make a formal complaint we can factor their experience into our discussions with the health board.

"There are people who are passionate about this and want to help. They can join us as volunteers and get involved directly with making the health service a better fit for the community's need.

Wrexham (Image: Staff)"On the subject of long waits in the emergency department, it is a complex, multi-faceted problem and it starts with the shortage of appropriate nursing home placements.

"Some of it starts with the problems the health board has in not being able to discharge people from beds because the support isn't available in the community.

"We're now looking at how people can be made more comfortable because ED units were made for waits of up to a few hours.

"If you're waiting 11 or 12 hours, there are things that can be done to make that experience better."

Speaking of the queuing ambulances, he added: "We hear from ambulance staff who go out, do a call and then get stuck at the Maelor. Sometimes they are there for their whole shift and they have to hand the ambulance over to someone else at the end of it.

"It's incredibly frustrating for them to hear all of these calls coming in and they are stuck because there's nothing they can do."

More information about Llais, and how to access support, can be found on the organisation's website.

What do the authorities say?
 

Lee Brooks, the Executive Director of Operations at the Welsh Ambulance Service, said: “Like our partners across health and social care, our ambulance service is also extremely busy.

“Pent up demand from the Christmas and New Year period, coupled with the seasonal illnesses we see at this time of year, means there are lots of people across Wales trying to access health services currently. 

“When hospitals are at full capacity, it means ambulances can’t admit their patients, and while they’re tied up at Emergency Departments, other patients in the community are waiting a long time for our help, especially if their condition isn’t life-threatening.

Queues at the Maelor Hospital (Image: NQ staff)

“We’re working really hard as a system to deliver the best possible care to patients."

Adele Gittoes, Interim Executive Director of Operations at Betsi Cadwaladr University Health Board, said: “The health and social care system across Wales is experiencing significant and sustained pressure. 

"This is having an impact on patient flow within our hospitals and waiting times in our Emergency Departments. 

"We are continuing to work closely with colleagues across the health and social care system, Welsh Government and the Welsh Ambulance Service Trust to identify ways to alleviate these pressures and improve the experience of our patients.

“It has been particularly challenging for urgent and emergency care across North Wales in recent days, with many patients presenting at our Emergency Departments requiring more complex care and treatment. 

"We apologise to those patients who have experienced longer than usual waiting times, despite the best efforts of our hard working staff."

A Welsh Government spokesman said: “We have a clear plan in place under special measures to support improvements at Betsi Cadwaladr University Health Board through focused interventions around quality, safety, and performance.

“While there have been signs of improvement since the health board was placed into special measures, we and the health board recognise significant challenges remain.

"We will continue to support the health board to ensure people in North Wales can see the necessary improvements in local health services.

“The health [board] has completed the expansion of Wrexham Maelor Hospital’s Emergency Department, which has created more consulting and treatment rooms for patients who need urgent care. It has also recently extended the opening hours of the Minor Injuries Unit in Mold Community Hospital. 

"The Minor Injuries Unit in Holywell Community Hospital is open seven days a week.

“We are investing in emergency care and extra community beds and continuing to integrate health and social care services to help improve patient flow through hospitals and tackle ambulance handover delays."