Britain’s heart care suffers as health system in crisis

COLCHESTER, UK, FEBRUARY 2 (Reuters) – In April 2021, Gary Cogan felt a slow, burning pain creeping up his right arm. It was the beginning of a major heart attack that warned that failure to do so could shorten his life by decades.

Nearly two years later, Cogan is still awaiting surgery from Britain’s overwhelmed health service. This is him among the millions who are suffering under the weight of an aging population, lack of investment, and his COVID-19 pandemic.

A 62-year-old warehouse worker in Colchester, southeast England, cut his workweek to three days out of fear of what he could do to provoke another attack.

He is one of the UK’s record 7.2 million people awaiting treatment with the UK’s National Health Service (NHS).

Long a source of national pride, its decline now dominates UK headlines, with videos on social media showing people getting treatment in hallways and waiting in trolleys for hours.

The UK’s cardiology department is the epitome of system-wide problems. A shortage of staff and years of stagnant investment have pushed the ward to its limits, with life-threatening consequences for patients.

Sonya Bab Narayan, a consultant cardiologist practicing in London, said Britain was in the midst of a “cardiovascular crisis”, with deaths from cardiovascular disease remaining high after the pandemic, with cancer and Deaths from other diseases are beginning to return to average trends, he said.

The British Heart Foundation charity says full treatment after a heart attack should begin within 18 weeks, but currently a third of patients are not seen within that time frame.11 In the month, about 8,000 people like Cogan had been waiting for heart treatment for more than a year, up from the dozens before the pandemic.

Since the pandemic began, COVID-19 and the resulting medical disruption have meant that on average 230 more people have died from heart disease than would normally be expected, and the rate remains high. as it decreases.

There are signs that routine care and surgeries are being disrupted due to the aftermath of the pandemic.

For example, the charity Cardiomyopathy UK found that for the specific heart condition, cardiomyopathy, four times as many people were diagnosed only on arrival at the hospital compared to before the pandemic. .

If a heart attack occurs, cardiologists say the patient should be in an ambulance within 18 minutes. The average waiting time for Corgan when he had a heart attack was 20 minutes. According to NHS data, the average ambulance wait time for such patients in December was 93 minutes.

Responding to Reuters questions about excessive death data and treatment delays, NHS England said heart disease patients were among the longest waiting for treatment, but the number of patients waiting more than 18 months was said to have decreased. NHS data showed that in November he had 18-month waiting lists, down 44% compared to the same month in 2021.

According to NHS England, teams are still trying to bring heart services back to pre-pandemic levels.

“Covid has inevitably had an impact, with fewer people coming forward for care,” the spokesperson said.

According to Babu Narayan, the pandemic has resulted in patients moving away from hospitals and their primary care physicians, booking fewer appointments and, as a result, receiving less preventive care. Diagnosis and treatment disruptions due to the pandemic, in addition to delays in emergency care, have had a huge impact on heart disease care, she said.

A lack of capital spending before the pandemic, when the government embarked on a nine-year austerity program, meant there were too few beds available, she said. A cycle of understaffing exacerbated the workload of doctors and nurses, causing more to leave.

“We know what to do. We know how to help, but the hospitals are full and there aren’t enough of us.”

The government has defended this, saying it is making record investments in health services, which account for 40% of daily government spending.

Prime Minister Rishi Sunak has made the restoration of NHS England one of his top priorities and said recent wait times were unacceptable, outlining a two-year recovery plan for emergency care this week.

Cardiac surgery aborted

Admitted to Basildon Hospital, 40 miles (64 km) from home after a heart attack, Cogan was diagnosed with severe left-sided coronary artery disease. Doctors told him that surgery to bypass his three clogged arteries would extend his life expectancy by 25 years and could be done in less than six months.

The operation did not materialize. Twenty-one months after the initial incident, more vague timelines came and went before he was finally given a January 2023 date. He then told him that with only four days left, the hospital had canceled due to lack of staff and beds.

At one point, Corgan even considered making himself sick by going running so he could “capsize” and have surgery soon.

He now has a new date for surgery on February 9, but he should be cautious and call the hospital the morning of surgery to see if a bed is available: “That’s a call you really don’t want to make.” is. .”

Awaiting surgery, Corgan was pictured affectionately at the opening ceremony of the 2012 London Olympics, where nurses and doctors applauded in the streets during the pandemic said he was so good when he saw them. But he said the service operates chaotically.

Even with his condition, he had trouble getting appointments with his local family doctor and getting medication. could not find a functioning ECG machine to read the electrical activity of the heart. The two hospitals disagreed on his priorities.

Neil Moloney, deputy chief executive of the NHS Foundation Trust in charge of Colchester Hospital, said the hospital has apologized for Cogan’s experience in 2021 and has since “reviewed and made improvements to our procedures”. Told.

The Mid and South Essex NHS Foundation Trust, which runs Basildon Hospital, said it was treating Cogan as a clinical priority, with surgery scheduled for February 9.

In line with the nationwide situation where people are coming to hospital with more problems or more serious conditions, Cogan has also developed a hernia and will not be able to operate on it until after his heart surgery. .

bed, staff, cash

In 2022, England and Wales will record 45,000 deaths, above the 2015-2019 average, making it the deadliest year for this indicator since 1951 outside of the COVID-19 pandemic.

About 2.5 million people have lost their jobs due to long-term illness, according to the Office for National Statistics (ONS), with minimum wage workers most affected.

The Bank of England has cited declining health as one of the reasons for reducing the size of its workforce.

According to the ONS, it’s too early to know what impact prolonged COVID and large waitlists will have on the workforce, but the government should be aware of the link between prolonged illness and people leaving work. are investigating.

Health services were struggling long before the pandemic.

Health care spending growth accelerated under the previous Labor government, contributing to the longest sustained real spending growth in NHS history, the Finance Institute said.

And when the Conservative Party came to power in 2010, health care costs did not fall sharply, but leveled off. IFS economist Ben Zaranko said Britain’s aging population is putting further pressure on his NHS budget.

“The NHS was steadily deteriorating in terms of its performance even before the pandemic,” he told Reuters.

According to the Organization for Economic Co-operation and Development, health spending as a share of economic output in the UK averaged less than 10% in the years leading up to the pandemic, while in Germany it is closer to 12% and above 60%. . We have more doctors per capita than the UK.

Between 2014 and 2019, the number of beds in UK public hospitals fell by 7%. This is the steepest decline among the Group of Seven (G7). The charity The Health Foundation estimates the NHS needs an additional 103,000 staff to meet demand.

It is such pressure that nurses are on strike this year for the first time in the union’s 106-year history.

Analysts say the recent additions could help raise staff salaries, but will not be enough to transform the NHS or prepare for future population aging.

The Nuffield Trust think tank says the enrollment of doctors from the European Union has slowed in the years since Britain’s decision to leave the European Union in 2016, possibly exacerbating staff shortages. I also discovered that there is

King’s Fund Chief Analyst Shiva Anandasiva, a charity working to improve health, says a combination of structural problems and pressure from COVID will make it 10 years before the NHS hits its targets again. He said it could happen.

“There are no short-term solutions here,” he told Reuters.

Additional reporting by Andy Bruce and Natalie Thomas.Edited by Kate Holton and Frank Jack Daniels

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