Award comes on the 73rd anniversary of the NHS’s foundation and marks only the third occasion on which the George Cross has been awarded to a collective body, country or organisation, rather than an individual.

The Queen has awarded the George Cross to the NHS recognising all health service staff in all four nations of the UK. In a personal, handwritten message, the Queen said NHS staff have carried out their work “with courage, compassion and dedication” for more than 70 years.

In her message, on Windsor Castle-headed paper, the Queen wrote: “It is with great pleasure, on behalf of a grateful nation, that I award the George Cross to the National Health Services of the United Kingdom. This award recognises all NHS staff, past and present, across all disciplines and all four nations.

“Collectively, over more than seven decades, they have supported the people of our country with courage, compassion and dedication, demonstrating the highest standards of public service. You have the enduring thanks and heartfelt appreciation of us all.”

However, The Doctors’ Association said better pay and conditions would have been welcomed instead. A spokesperson for the lobbying and campaigning group told i: “This is a similar gesture to the Thursday night clapping, which acknowledges the part NHS staff have played in this pandemic. However what the NHS actually needs is not shiny medals, but appropriately paid staff, who feel able to go to work without fear of abuse, to work in an environment with adequate staffing and resources.”

Read the full article here.

Today we learnt that we have more patients with COVID in hospital than ever before in England. This is not a drill. Please believe us.

The country is “back in the eye of the storm”, according to the head of the NHS, with the number of patients being treated for COVID-19 in England’s hospitals overtaking the peak back in April.

Figures from NHS England have revealed that there were 20,426 patients being treated in hospitals as of 8am on Monday, compared with the 18,974 patients recorded on 12 April.

Also on Monday, the UK recorded its highest daily increase in coronavirus cases since the pandemic began with 41,385 positive tests.

During a visit to an NHS vaccination centre, the chief executive of the NHS, Sir Simon Stevens, praised staff but said: “Now again we are back in the eye of the storm with a second wave of coronavirus sweeping Europe and, indeed, this country.

“Many of us have lost family, friends, colleagues and – at a time of year when we would normally be celebrating – a lot of people are understandably feeling anxious, frustrated and tired.”

But sounding a note of hope, Sir Simon added: “We think that by late spring with vaccine supplies continuing to come on stream we will have been able to offer all vulnerable people across this country COVID vaccination.

“That perhaps provides the biggest chink of hope for the year ahead.”

His comments come on the day that the patients who received the first vaccinations three weeks ago will receive their booster jab.

They also come as the pressure continues to grow on the NHS at a time of year that is already difficult.

Dr Samantha Batt-Rawden, president of the Doctors’ Association UK, said in a widely shared Twitter thread that she and her colleagues are “at breaking point”.

The senior intensive care registrar wrote:

Today we learnt that we have more patients with COVID in hospital than ever before in England. This is not a drill. Please believe us.

We are incredibly thin on the ground. NHS staff have not been prioritised for the vaccine and are going off sick in droves with the new strain.

Trusts are so desperate they are tweeting out for medical students to help in ICU. This was confirmed by a consultant on the ground.

When staff have spoken up on Twitter they have been told this is all a hoax. It’s not.

Try holding an iPad for a patient to say goodbye to their family. Or having to ventilate a colleague. This is real and happening right now. Staff are broken and need support now more than ever.

Read the rest of the article here.

Read the Twitter Thread by clicking on the highlighted date below:

I run a network for over 46K doctors. Things are really bad on the frontline and NHS doctors need help getting the word out.

NHS hospitals in England are under increasing pressure as coronavirus cases rise, with doctors raising the alarm about “very, very busy services” and one trust calling for volunteers to help prone patients.

The warning comes as the number of coronavirus patients in hospitals surpassed the peak of the first wave – up to 20,426 as of 8am on Monday, more than April’s high of 18,974. Health officials in Wales and Scotland have also said they fear becoming overwhelmed.

The UK reported 41,385 new lab-confirmed cases on Monday, the highest figure yet for a single day.

Matthew Kershaw, the chief executive of Croydon Health Services NHS trust, told BBC Radio 4’s Today programme that hospitals were “very pressurised” and “very, very busy”.

There were also calls for new national coronavirus restrictions to prevent a “catastrophe” at the start of 2021, from a leading infectious disease expert.

Andrew Hayward, a professor of infectious diseases epidemiology at University College London, told Today: “I think we are entering a very dangerous new phase of the pandemic and we’re going to need decisive and early national action to prevent a catastrophe in January and February. 

“A 50% increase in transmissibility means that the previous levels of restrictions that worked before won’t work now, and so tier 4 restrictions are likely to be necessary or even higher than that.

“We’re really looking at a situation where we’re moving into near lockdown, but we’ve got to learn the lessons from the first lockdown.”

Kershaw said capacity had been expanded in Croydon, alongside hospitals around the capital and across the country. He said: “So we have responded, thus far, well to the needs of our population.”

He added: “It is very, very busy … and it’s a really important and difficult moment but we are responding well at this moment.”

Samantha Batt-Rawden, an NHS critical care doctor and the president of Doctors Association UK – a union that represents frontline medics – expressed her exasperation on social media.

“Hospitals are running out of oxygen. One trust has no non-invasive machines left. ICUs are tweeting for volunteers to prone patients. Transfer teams being requested to move patients 65-plus miles to the nearest hospital with critical care capacity. Please. Stay at home if you can.”

Batt-Rawden shared a tweet from Cardiff and Vale University health board, which has since been removed, that read: “Our critical care department is urgently looking for assistance from medical students or other staff groups who have previously supported with proning patients.”

“Proning” is the process of getting a patient on to their front. Getting someone into this position helps patients with acute respiratory distress.

Batt-Rawden said: “Please help NHS staff speak up about how things are on the frontline. It’s dire. And we are shouting it from the rooftops.”

Read the rest of the article here.

Read the rest of Dr Batt-Rawden’s Twitter Thread by clicking on the highlighted date below.

Hospitals are running out of oxygen.

One trust has no non-invasive machines left. 

ICUs are tweeting for volunteers to prone patients.

Transfer teams being requested to move patients 65+ miles to nearest hospital with critical care capacity. 

Please. Stay at home if you can.

NHS staff are at breaking point. They are trying to speak up about how bad things are on the frontline but are being shot down on Twitter. Today we learnt that we have more patients with COVID in hospital than ever before in the England. This is not a drill. Please believe us

Doctors across the country have warned hospitals are becoming overwhelmed amid a surge in coronavirus patients over the Christmas period, as they urged the public to stick to lockdown rules.   

Hospitals in England are now dealing with more Covid-19 patients than during the peak of the first wave, with figures showing there were 20,426 in NHS hospitals on Monday compared with 18,974 recorded on April 12. 

The number lab-confirmed cases in a single day in the UK also hit a new high of 41,385 on Monday, rising above 40,000 for the first time, according to Government figures.

Mervin Singer, professor of intensive care medicine at University College London, told LBC’s Andrew Castle on Tuesday: “I’ve been doing intensive care for 30-odd years, I’ve never seen anything like we’re experiencing at the moment. 

“Now we have the double whammy of sick people who don’t have Covid and this huge, huge surge of Covid patients who are incredibly ill and compounded by lack of staff – a lot staff members are going off sick and either having to isolate or there’s a huge amount of burnout and stress – it’s completely unusual.” 

Prof Singer said at some hospitals “huge numbers of patients are just piling up on the front door”.

Many medical professionals have taken to social media to express concern that people are not taking the situation seriously by flouting Covid-19 restrictions. 

Dr Samantha Batt-Rawden, president of the Doctors’ Association UK, warned: “Hospitals are running out of oxygen. One trust has no non-invasive machines left. ICUs are tweeting for volunteers to prone patients. Transfer teams being requested to move patients 65+ miles to nearest hospital with critical care capacity. Please. Stay at home if you can.” 

She added: “NHS staff are at breaking point. They are trying to speak up about how bad things are on the frontline but are being shot down on Twitter. Today we learnt that we have more patients with COVID in hospital than ever before in the England. This is not a drill. Please believe us.”

Read the rest of the article here.

The review began in 2018 and the latest document acknowledges that the pandemic has further reduced bed capacity.

DAUK’s president, and senior registrar in emergency and intensive care medicine, Dr Samantha Batt-Rawden commented:

“The 4-hour target is considered by many frontline doctors as not fit for purpose, with patients continuing to wait hours in Emergency Departments this winter as in many recent winters.

“We are pleased that NHS England is launching this consultation in partnership with frontline staff to develop alternative patient-focused targets; going forward we must ensure that these are backed up with the staff and resources to achieve them.”

The article can be found here.

NHSE will be launching a consultation into the current four-hour target in emergency departments across the NHS. Doctors’ Association UK has been invited to be one of the expert groups providing input in this consultation. This is an extension of the current review, which began in 2018 and was due to conclude in Spring 2020 but was delayed by the COVID-19 pandemic.

The four-hour target has been a contentious point amongst health professionals working in emergency medicine for many years. Whilst it has allowed an increase in focus and funding for A+E departments that was previously lacking prior to its introduction, it has at times been a blunt and sometimes misleading measurement. Despite this there have so far been no viable alternative targets suggested. After several years of this target largely being ignored as a metric – The NHS has not met the four-hour standard at national level in any year since 2013/14, and the standard has been missed in every month since July 2015. Between 2011/12 and 2018/19, A&E attendances grew on average by 2.1 per cent each year and increased by 3.3 million (16 per cent) in total. This is the equivalent of an extra 9,200 A&E attendances each day. Given this increase – alternatives need to be evaluated to ensure optimal patient care.

Dr Samantha Batt-Rawden, President of the Doctors’ Association UK and a senior registrar in emergency and intensive care medicine said: 

“The 4-hour target is considered by many frontline doctors as not fit for purpose, with patients continuing to wait hours in Emergency Departments this winter as in many recent winters. 

We are pleased that NHS England is launching this consultation in partnership with frontline staff to develop alternative patient-focused targets; going forward we must ensure that these are backed up with the staff and resources to achieve them. 

Doctors have repeatedly told us of dire working conditions on the frontline. NHS staff are working themselves into the ground to keep patients safe during the worst winter on record. We must ensure that this move is not an attempt to deflect accountability for spiralling wait times in Emergency Departments as a result of years of under-resourcing.”

Doctors’ Association UK looks forward to working with NHSE and other expert groups to ensure that measures of emergency department performances focus on patient safety and quality of care as well as efficient treatment.

Read the ‘Transformation of urgent and emergency care: models of care and measurement’ report on the NHS England website, now publicly available here.

CONTACT

Press@dauk.org

¹The Doctors’ Association UK (DAUK) is a professional association for UK doctors. Run by frontline NHS doctors, DAUK campaigns for patients and the NHS as well as advocating for the medical profession

NHSE agreed information being released to the public at the same time as doctors is not acceptable and will make every effort to ensure this does not repeat. As part of their media campaign, they have advised patients to wait to be contacted about the vaccine and not to contact their surgery. We welcome this move.

DAUK raised a few further concerns:

1. Practices are worrying about financial liability. We have requested more vocal and contractual support financially for PCNs taking this risk, as well as appropriate media coverage to ensure those unable to will not suffer a backlash.
2. GPs are worried that routine work will suffer at the expense of the vaccine due to staffing issues. We have asked to know what the long term strategy for this is.
3. CCGs are pressurising practices in some area. We have asked NHSE to contact CCGs and remind them to be supportive.
4. DAUK asked for reassurance that no changes will be made unilaterally to the DES without prior discussion

Download and read our full Statement here:

Even a fully staffed and rested workforce would find this combination a challenge. Before the pandemic, the NHS was short of 106000 staff. Now, a chronically short staffed and fatigued workforce looks at the upcoming winter with great trepidation.

Waiting lists for extremely serious surgeries look set to double while more than 50,000 patients have not waited more than a year for NHS treatment. Given this, with the additional pressures of rising coronavirus cases, NHS workers need a viable and realistic strategy both to cope with the exhaustion they feel from the initial impact of the pandemic and the increased pressures the winter will bring. This will require genuine additional funding, rather than talking up and repackaging old promises. Further, there must be a strong focus on staff retention.

Without improved working conditions, DAUK fears the UK will witness increasing NHS workforce shortages with burnt-out staff quitting or reducing hours, resulting in even greater waiting lists. This will have knock on effects on an already strained economy with increased numbers of unable to work while awaiting treatment. Given this, this impending challenge must be treated with utmost gravitas.

To achieve such a strategy needs an inclusive team from all parts of the NHS contributing to a workable plan rather than relying on consultancies that have little experience on the ground.

In the immediate term, a functional and efficient testing system will go a long way towards helping to reduce the effect of coronavirus on the NHS and help reduce the burden on our services.