AS a junior doctor working in hospitals across the North-East, this winter is again proving tough. Last year the Red Cross warned of a “humanitarian crisis” on NHS wards and similarly this year the headlines are brimming with news of how stretched services across the country are.

Despite the warning signs and a commitment by the government to improve services this winter, the NHS once again finds itself at crisis point. While the heightened pressure at this time of year attracts the media’s glare more often than usual, pressures of this kind are no longer confined to the winter period as sustained year-round pressures are becoming the norm.

As an A&E doctor, my immediate focus is on treating the patients that come through the door and ensuring they are cared for during their stay in the emergency department. The immediacy of this contact can seem a world away from the political decisions regarding the funding and organisation of our health service, yet decisions of this kind eventually filter down to the day-to-day running of our hospital wards impacting the patient-doctor relationship.

Jim, one of my late middle-aged patients came to us very worried about chest pains that had been bothering him throughout the Christmas period. Tests revealed that he was having a heart attack and needed urgent attention. Potentially fatal situations like this highlight the need for an emergency department to run efficiently so patients like Jim can be are seen-to in time.

While patient care is always a priority, increasing pressure on emergency services, particularly in the busy winter period, means that waits are inevitable, and staff are having to go above and beyond to deliver the care patients expect.

Though my hospital ranks among the best for A&E waiting times in England, largely down to the incredible dedication and hard work of frontline staff, it is by no means perfect. Individual acts of heroism can only do so much and stretching staff to deliver consistent patient care in a challenging environment comes at a cost.

Increasingly, NHS staff are being subjected to unacceptable levels of pressure which can lead to more significant health concerns such as stress and burnout and the long-term health implications this carries. It is difficult to watch my colleagues struggle in this way.

The British Medical Association is currently running a campaign to tackle stress and fatigue among doctors focusing on improving their health and wellbeing by promoting the use of the Headspace mindfulness app and encouraging staff to take breaks. Whilst this is a positive step and encouraging, breaks of this kind should be a given and not a luxury.

LIKE many of my colleagues, I worry that the care that I am giving to my patients isn’t the standard that they deserve. When holding the hand of a relative when I explain that their father is dying and there is nothing more that we can do. When trying to simplify and clarify the complicated medical problems of a patient being admitted with sepsis. When trying to guide a patient with a head injury on when and why they would need to return to hospital. This takes time, compassion and energy – all of which are in short supply.

For Katie, the toddler who came in over the festive period with a head injury, despite the pressure on services that day, it was the hard work of staff on the ward who made sure that she was treated within hours so that she left with smile and was able to go back and open her presents.

I fear for those patients who may not have had the same treatment this winter and for the many patients across the country who will be unsure what they are met with when they walk through the A&E doors.

In the North-East, there are fears that proposed sustainability and transformation plans in the area could impact the delivery of patient care if downgrades to a number of emergency departments in the region go ahead.

What is happening in our A&Es is symptomatic of wider pressures across the entire system with GP surgeries overstretched and a shortage of social and community care feeding into the wider crisis. We must all work together to find a solution that protects the founding principles of the NHS and provides the resources, staff and funding to deliver the healthcare service we all deserve and need.

I can only look to the future and hope for a resolution but for the staff working tirelessly on the wards and the patients in need of care this winter in hospitals across the North-East, the pressure shows little sign of slowing.

  • Dr Peter Campbell is a junior doctor working in emergency care in the North-East and the deputy co-chair of the BMA junior doctors committee