‘There is a revolving door of patients’

By Nick Triggle
BBC News health reporter

The buzz word in the NHS at the moment is efficiency.

Dr McCarthy is concerned about the future

But according to doctors in Shropshire it has gone too far.

"I have heard of one hospital bed being used by four different patients in the space of 24 hours," said Shrewsbury GP Dr Mary McCarthy.

"What impact do you think that has on infection control? It has just gone too far in the health service now. It is a revolving door of patients."

My concern is that the emphasis on cutting bed numbers and saving money means there are other hospitals out there which are on the verge of the same situation Dr Mary McCarthy Shrewsbury GP

Dr McCarthy believes it has got so bad that there are other hospitals which are at risk becoming "another Stafford".

The hospital became synonymous with bad care earlier this year when a highly-critical report by NHS regulators said people had died unnecessarily because of poor emergency services.

Among the catalogue of shocking revelations was the discovery that receptionists were being used to assess patients.

Modern medicine

Dr McCarthy, as chairman of the local GPs committee, is meeting with managers this week to discuss her concerns.

She said because of the closure of community hospitals Shropshire has lost 300 hospital beds over the past 10 or 15 years.

"On top of this, we are seeing more admissions," she said.

If you have to put health of the budget ahead of health of the patient quality will suffer Dr George Rae British Medical Association

"Last weekend one consultant told me there were 50 admissions when three or four years ago there would have been about 20.

"It is all to do with modern medicine. As GPs, we are told to admit all patients with chest pains.

"Guidelines say stroke patients have to be admitted for scans and specialist treatment and with an ageing population we are seeing more admissions among patients who have side effects from their treatment.

"But it has now got to the point where there is a pressure on GPs not to admit because there are not enough beds.

"Patients are also discharged too quickly and have to be readmitted. That is bad for the patient, but is also a waste of resources for the NHS.

"We should just be getting the treatment right in the first place."

But does this amount to a repeat of the mistakes made in at the hospital run by Mid Staffordshire NHS Trust?

After all, regulators have said that there are no other NHS trusts being investigated for the problems that emerged there.

Dr McCarthy acknowledged it does not.

But she added: "My concern is that the emphasis on cutting bed numbers - per head of population the UK has much fewer beds as places such as France and Germany - and saving money means there are other hospitals out there which are on the verge of the same situation."

It is a view shared by the British Medical Association as a whole.

The union's annual meeting in Liverpool voted in favour of a motion warning that the problems highlighted in the case of the Stafford Hospital were at risk of happening elsewhere.

Finance a priority

Dr George Rae, a GP from the north east who put forward the motion, said the whole health system is geared up to making finances a priority because of the emphasis placed on gaining foundation trust status.

Foundation trusts are hospitals - and other providers such as mental health units - which are given freedom from central control.

To be granted the elite status, trusts must show that they can balance the books.

Dr Rae said: "If you have to put health of the budget ahead of health of the patient quality will suffer.

"My concern is that the pressures on Mid Staffs are being seen in hospitals up-and-down the country."