'We need to ask ourselves what exactly went wrong': Senior doctor speaks out on problems at Wigan's hospitals

Prof Ayaz Abbasi, consultant in emergency medicine and clinical director for quality and safety at Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust (WWL), believes more help should be available in other parts of the health and care sector to prevent people turning up at A&E.

He is so concerned about Wigan’s hospitals – where he has worked since 2009 – that he took the unusual step of contacting the Wigan Observer to highlight the problems.

Prof Abbasi said: “As a senior physician for the last 26 years, I never thought that in the sixth richest country in the world, we would be treating patients in corridors and waiting rooms. We need to ask ourselves what exactly went wrong and how can we work to make it right.

"Of these patients who are waiting for days for hospital beds, most of them are elderly, sick and vulnerable. We are letting them down.

"In the last year, there were 1.8m patients who waited for more than 12 hours in emergency departments for a bed in the hospital from the time of their arrival. Before 2020 I had never witnessed a 12-hour trolley breach in the hospital where I work, but as of last week, we’ve had several daily.”

Prof Abbasi believes one of the main causes is that there are 29,000 fewer beds in hospitals across the country than there were in 2010.

While the borough used to have five hospitals, the closures of Billinge Hospital and Whelley Hospital have left Wigan Infirmary, Wrightington Hospital and a downgraded Leigh Infirmary.

He said: “We have a population of 330,000 living in the borough of Wigan and a hospital which has got only 500 beds. In Greater Manchester, Wigan is the most deprived borough in many ways. There is a large increase in the elderly population here as well.

"If you calculate the hospital bed base compared to 1,000 of the population in the borough, it is the lowest number in Greater Manchester compared to any district general hospital. Salford has half the population of Wigan but three times the number of beds.”

Prof Abbasi says he has seen the impact of budget cuts on the NHS since the introduction of austerity in 2010.

He sees people go to A&E who could be supported elsewhere, such as for drug and alcohol problems or mental illnesses, but are finding it difficult to get help as other services are also struggling.

And some patients remain in hospital despite being well enough to leave, because there is nowhere for them to go.

He said: "It’s basically the patients are coming because they can’t get appointments in primary care. Social services are struggling so the people who are admitted, more than 100 patients at the moment are medically fit to go home but can’t go because there is no capacity in social care to accept them.”

Prof Abbasi is calling for extra beds and action to improve capacity in other parts of the health and care system.

He said: “NHS needs more investment and efficiencies to improve its performance. NHS is the best healthcare system in the world and needs to be saved at all costs.

"The Government needs to realise that closing 29,000 beds was a mistake and needs to reinstate the bed base necessary for our ever-growing elderly population with complex needs.

"Mental health, social care and community services should be properly funded. Homelessness and drug and alcohol problems should be investigated, and a long-term strategy should be made so that these people don’t use acute services which are for critically, unwell patients.

"Zero tolerance for patients being treated in corridors and waiting areas. This is most undignified for patients and staff.”

He also wants the problem to be recognised through an apology.

He said: “I think there should be some apology from whoever made the decision to cut beds and close down the hospitals in the borough, without forward thinking about what would happen in a few years time when there is an elderly population and fewer beds in the system.”

Despite his concerns, Prof Abbasi was keen to highlight that he was not criticising his colleagues or the hospitals where he works.

"I know that all the staff are working their socks off,” he said. “They are working very hard, under tremendous pressure.

"It is not their fault that there are no beds in the system or that someone made the decision to close down the hospitals.”

WWL’s medical director Prof Sanjay Arya said: “WWL’s emergency department is under continuous high demand and unfortunately this has meant patients are experiencing long waits, for which we offer our sincere apologies.

“The trust is aware of escalated areas, but patient safety remains paramount and arrangements have been put in place to keep our patients safe.

“We are working with our system partners on a daily basis to meet emergency demands and we constantly ask patients to use A&E appropriately for life, limb and sight-saving emergencies.

“Our staff work incredibly hard every day and night, ensuring our patients are treated with care and compassion. I would like to thank each and every one of our staff for their continued hard work.”

A Department of Health and Social Care spokesperson said: “The NHS’ Urgent and Emergency Care Recovery Plan, backed by record funding, has already improved A&E performance and ambulance response times. Thanks to that plan the NHS is getting 800 new ambulances, 5,000 hospital beds and 10,000 virtual ward beds to treat people from the comfort of their homes.

“Hospitals are on track to deliver the additional permanent beds by the end of the year, so more than 99,000 core beds will be in place across the country by December 2023 – thousands more than last year.”