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NHS in crisis – what is responsible for 10,000 extra deaths this year?

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    A significant increase in the number of deaths in England and Wales this January and February have rung alarm bells amongst health experts who believe the NHS is struggling to cope.

    Is the Government doing enough to establish the cause of the increase, putting in place the changes and resources necessary to stop the trend, and ensuring those who are sick get appropriate and timely treatment?

    By Ali Cloak

Casting our minds back to the start of 2018, there were numerous news reports of long waiting times in hospitals, patients waiting in corridors to be treated, and the cancellation of tens of thousands of operations.

Figures analysed by medical experts at the British Medical Journal show that 10,375 additional people died in the first seven weeks of 2018 than compared to previous years. The big question this raises is: what was the cause, what can be done and were these deaths avoidable?

The facts and figures

Over the past five years, an average of 83,615 people died in the first seven weeks of the year. This year the figure was 93,990. That’s an extra 10,375 deaths, a rise of 12.4% or an extra person dying every seven minutes.

It’s not down to an ageing population

The Government often states how the NHS’s main issue is that it is struggling with an ageing population and that with the population growing older, there are more strains on our public resources. But is old age the reason for such a dramatic increase in deaths this winter?

The medical experts do not think so. They say that ageing simply does not lead to a sudden increase such as the one seen this year; if it were ageing, we would have instead seen a slow, steady rise in the numbers. The experts stress that this sudden jump in mortality must be due to something else.

The Australian Flu – not as much of a factor as you’d think

You may remember hearing more adverts this year reminding you to get a flu vaccination, particularly if you are in a group particularly vulnerable to the virus, such as the elderly or asthmatic. This was part of the NHS’s effort to protect the population from the effects of “the Australian Flu”, a severe strain of the influenza virus that had caused a bad epidemic in Australia.

Was this virus the reason for the rise in deaths in 2018, then? Apparently not. The figures show that the proportion of deaths where the flu or pneumonia was considered an underlying cause, was not unusually high and could not account for the increase in deaths that has been seen.

Perhaps the snow and cold weather? Wrong again

There is no need to remind anyone about the recent cold weather and snow piled high across the country.

However you may be surprised to hear that, overall, the weather in January and February was actually incredibly mild compared to other years and actually we saw above average temperatures recorded for the first seven weeks of the year.

So, it would appear nothing unusual about the weather would have caused such a leap in the mortality figures.

It’s not even down to cancelled surgeries

What to think of the NHS strategy to cancel elective surgeries? Did this cause the rise in deaths?

It is in fact very unlikely, as the cancellation of surgeries were those that were ‘elective’. This means non-urgent operations that can be re-arranged without risk to the patient.

The reason so many operations were cancelled was that the NHS was overcrowded. There were limited beds for incoming patients and many wards were full due to being unable to discharge many elderly people safely back to their own homes or to care homes in the community.

It is thought that the cancellation of these operations may have actually made the hospitals safer as, if they had gone ahead, there would have been even fewer beds and staffing for incoming sick patients needing emergency treatment.

So what is the cause?

The truth is that there is no obvious answer as to why there were so many additional deaths this year.

The medical experts who looked at the figures point to the fact that the spending on health and social care has become more limited, and that there has been a rapid increase in the number of those with mental health issues dying whilst in the care of the state.

That is why it is imperative that the Government investigate these figures further and to undertake a detailed review to identify the cause of such a sudden increase in mortality.  In the absence of a robust review it is impossible to tell whether any of the deaths were avoidable. Even if only a small percentage of the total increase were deemed to be avoidable deaths that is still of huge concern.

Without identifying the cause, or causes, there is no way to put in place the changes to make a difference and to ensure the figures do not rise again next year. We eagerly await confirmation of the timescale for such an investigation to be carried out.

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