The RCP has launched a new report calling for investment in ‘hospital at home’ services that provide specialist medical care in the community across Wales. These teams can help to reduce hospital admissions, get people home more quickly, and improve the quality of patient care.
Lengthy stays in hospitals can increase the risk of hospital-acquired infections, including COVID-19. Keeping older people out of hospital and in their own home has never been more important. Over the next few months, the vision of care closer to home as set out in A Healthier Wales, the Welsh government’s long term plan for health and social care must be supported by a significant investment in community resource and staffing, especially in intermediate care. This means:
- Better regional collaboration and clinical networking across health boards.
- Investment in training more clinicians to work in the community.
- Rapid access to the right diagnostics and interventions.
- Closer working relationships with therapists, social care, and palliative care teams.
Supported by the British Geriatrics Society, this new report comes as the latest RCP membership survey found that almost two thirds (63%) of respondents in Wales said they had felt overwhelmed at least once while at work in the past 3 weeks. One in six (17%) told us they felt overwhelmed almost every day.
This is likely due to high levels of staff absence which is still putting immense strain on exhausted and demoralised staff working under the extreme pressure of rising COVID-19 cases coupled with usual winter illnesses. With so many people off work, over half of respondents (52%) in Wales had been asked to cover rota gaps at short notice in the previous three weeks, and almost a third (30%) had been asked 3 times or more, adding yet further stress to their working days.
While staff absence has been felt acutely during the pandemic, much of the pressure stems from workforce shortages that existed long before COVID-19. Even before the pandemic, we struggled to recruit, and this year, 59% of consultant physician posts advertised in Wales went unfilled. That’s 3 in every advertised 5 posts remaining empty –in 63% of those cases, it was because there were no applicants at all. The situation is not sustainable.
Dr Olwen Williams, RCP vice president for Wales said:
‘There are some very difficult choices ahead to try and reduce waiting lists and put the NHS back on a sustainable footing. But what is clear is that a lack of workforce across all professions will continue to limit our recovery. Increased investment in the NHS cannot improve patient care if we don’t have the staff to treat patients. This shouldn’t be about doctors taking on more and more patients until people simply burn out.
‘We need to increase the number of medical students and postgraduate trainees to prepare for an ageing population. This year, more than half of advertised consultant posts in Wales were unfilled due to a lack of suitable applicants. These rota gaps meant that an over-stretched NHS came close to breaking during the pandemic.’