Meeting the Target - The NHS and A&E

With the population as large as ever in the UK, subsequently in the last few years there has been a noticeable and increasing strain on NHS services across the board. However I believe, along with many others, that the Accident and Emergency Department can be considered to be under the biggest of pressures today. A programme on the BBC I watched recently showed exactly the effects of this population pressure on staff and patients alike. The Panorama documentary was a rather short 30 minutes, nevertheless a real eye-opener to the general public to appreciate the scale of the problem.

I encourage you to see it and I have embedded the video below:


What I found quite shocking is that many of the staff are under constant pressure from the many patients who arrive to the hospital every hour. However it isn't just the local pressure - government-set deadlines and targets ensure the conveyer belts of NHS services are rolling quickly. One doctor in the film says "it's a more stressful place to work than it once was"when referring to the A&E Department of today.

Judging from the documentary, the staff seem stressed, however I deeply respect their professionalism as when dealing with the wide variety of patients, they control their emotions. This is vital when dealing with the public and representing an organisation as important as the NHS. One example from the clip I especially remember is when a heavy alcoholic was admitted to A&E. His rowdy, agitated and rather unpredictable manner meant the nurses in particular were dealing with a tough patient. Refraining from raising their voice too much, they managed to control the patient. In fact if he had turned very aggressive, the staff may have been at risk from harm. The number of alcoholics and drug abusers admitted to A&E is alarming, and they are transported to hospital 'around the clock'. For this hospital alone there are '3 to 4 overdoses a day'.

The pace at which staff need to work is tremendously quickly, whilst being efficient. It shows how training is vitally important to sustain such roles in the health service.

In the video, I was rather interested to see that one GP said that she once wanted to work for the A&E department of the NHS as it suited here own interests. However she ended up settling for a job less manic as a GP, as she no longer wanted to be part of a "sinking ship". She is clearly an experienced health professional, and I respect here view which is why I appreciate the scale of the problem we face in A&E.

One of the major problems in fact is the limited number of hospital ward beds available to patients after they leave the A&E department. Some patients are left to wait hours. The large number of patients poses a dilemma. The NHS need to strike a balance between treating as many people as possible and giving each patient the thorough and correct care they need to make a good recovery.

Solutions to the problem are already being implemented. However many people simply aren't aware of alternative healthcare services that have been made available by the NHS. Walk-in centres and dialling 111 are just a named couple that one could use in out-of-hours for GP's instead of visiting A&E. More awareness is needed to inform the public that personal health advice is available very readily on a local level and is easily accessible.

Rise of Antibiotic Resistance Means 'We are all to blame'

One of the biggest stories in the media brewing at this present time is the consequences of further antibiotic resistance to our current and best antibiotics. Perhaps UK Prime Minister David Cameron is a tad too late to say that this could mean an eventual turn to the "Dark Ages" with our current progress with developing new antibiotic drugs.

Mr Cameron has stated that 'governments and drug companies [need to] work together to "accelerate" the discovery of a new generation of antibiotics'. However, common knowledge of the drug trial system explains that these new drugs won't be available for prescription tomorrow - in fact some particularly gruelling clinical trials can take up to 15 years according to Cancer Research UK. With the alarming rate of increasing antibiotic resistance, perhaps the development of new solutions may not be able to keep pace with the continuing evolution of bacteria. These bacteria acquire 'antibiotic resistance genes' with new, random mutations to their genetic sequences.

Max Pemberton writes for The Daily Telegraph that discovering new antibiotics would be 'nothing more than a sticking plaster, concealing an underlying wound that we all need to accept exists'. Personally I fear he may be probably right, with increased application of antibiotics, there is an inevitable increase in the probability of antibacterial resistance due to mutation.

Although at present we 'render [antibiotics] useless', it seems that it is our only solution to the evolutionary suberbugs. In evolutionary terms, microorganisms such as bacteria can be considered the most successful organisms ever to have inhabited this earth. Their numbers growing incomprehensibly larger.

It is a frightening prospect to know that our seemingly useless drugs are being made to look an insignificant problem to microbes. It is absolutely imperative that scientific researchers all over the world work together to investigate new approaches to tackling this ever-pressing, escalating problem.

But what escalates antibiotic resistance? Pemberton makes a good point that partly it is due to human activity and more particular - our greed. Mass factory farming for example allows diseases to spread 'like wildfire' - this would require mass doses of antibiotic in turn. There has been evidence to suggest farmers treat even healthy livestock with antibiotics, this will fuel further the rise of antibiotic resistance. Measures like banning factory farming and limiting the use of antibiotics on animals could contribute to a long-term solution. But it would be no easy task I guarentee. I am sure many people would appreciate a rise in price of meat if it means combating the problem we face.


This pressing issue has brought about recent changes in the primary care system of the UK for example. Doctors (GP's) have been told to 'make patients wait five days for antibiotics', according to Christopher Hope, Senior Political Correspondent of The Daily Telegraph. This suggestion has been made in an attempt to 'wean people off a reliance on the drugs'. This step is one in a series of others aiming to reduce the need to give people antibiotics inappropriately.

GP's are often pressurised into prescribing antibiotics, some patients insisting that is what will treat their problem. Sore throats are an example: the measures would cut the need to prescribe antibiotics for sore throats 'from 90% to 40%'.

However prescribing the antibiotics in the first place isn't the only issue - how do we monitor the patients taking the drugs after prescription? As a general rule, it is essential for patients to complete a course of antibiotics. Secondary responses of diseases such as with Tuberculosis are possible.

Andrew Miller MP, chairman of the committee for MP's, said it had heard of 'GP's prescribing antibiotics simply as "dummy" placebos', in the attempt to satisfy patients.

In fact according to the article, since 2000 'only five new classes of antibiotic had been discovered and most were ineffective'. Ineffective against Gram-negative bacteria that is. These are bacteria that do not stain using the Gram staining method.

I am keen to see how the UK government will deal with this issue in the near future...

Credit to Max Pemberton and Christopher Hope (Senior Political Correspondent) for their articles in The Daily Telegraph (UK) published on Monday 7th July 2014.