A day in the life of A&E staff: How the NHS has changed

  • Video report by ITV News Health Correspondent Emily Morgan

With an increasing number of patients waiting more than four hours to be seen at A&E departments, latest figures have revealed the true scale of stress the NHS is under.

December saw a record number of attendances and ambulance callouts.

In light of this, ITV News Health Correspondent Emily Morgan spent a day with one team of paramedics, who opened her eyes to how their role has changed.

Health Correspondent Emily Morgan joined paramedics at the start of their 6am shift. Credit: ITV News

It's 6.15am in the morning and members of the North East Ambulance Trust were gathering at their base in Blutcher, Newcastle, to start their 12 hour shift.

We were joining them for the day to see how the service is coping with increased demand and who is using it.

Our guide was Paul Spraggon, a tall, burly bearded man who's worked as a paramedic for 27 years: his first piece of advice was that we won't see what we're expecting.

This confused me a little and I questioned him further, why I asked, what do you think I'm expecting? He explained that everyone thinks paramedics spend their day rushing from one trauma to another, attending RTCs (road traffic collisions) and dealing with multiple patients suffering horrific injuries.

Sure that happens, he says, but not everyday, in fact that's pretty rare.

It's 6.30am now and the first call comes in. We leap into the car and speed to the address of an elderly woman who is suffering from breathing problems and a painful hernia.

Her son hurries us into their block of flats and we cram into the tiny lift. The crew, Dan and Peter, go into the flat ahead of us and find Audrey in her bedroom, dressed and ready go.

She's checked over, blood pressure is taken and questions asked. Audrey says she's been in pain all night and her current pain killers aren't controlling it, she also says it's causing her breathing difficulties.

Audrey is 83, her son is about to leave for work, she doesn't have a care package in place and her doctor's surgery doesn't open for another hour and a half.

Dan and Peter decide that, taking all those factors into account, Audrey should be taken to A&E. I ask if she really needs to go to A&E and they agree that yes, given that she needs more pain killers and the fact that she shouldn't be left alone, A&E is the safest place for her.

Audrey is bundled into the ambulance, driven to and handed over to the Royal Victoria Hospital. I have to admit, the first call out was not what I was expecting.

Then the second one came in... off we went, to another block of flats and another woman, this time in her late sixties and this time lying in the corridor.

It was quickly obvious to the paramedics that she was a regular caller, she'd hurt her knee she said and couldn't stand up to get back into her flat.

At this point Paul took us aside and told us this was a social welfare issue, the woman in question in all likelihood wanted to go to A&E for company or attention but because she was complaining of a painful knee and she didn't have anyone to look after her or to take her to the doctor they were duty bound to take her to A&E, which they did.

Audrey, 83, was taken to hospital suffering from breathing problems and a painful hernia.

To my surprise, the day went on like this. Patient after patient we attended to was elderly and in need of some sort of care but in most cases not A&E.

Why then, I asked, did the paramedics feel it necessary to take them to A&E?

In every case, bar one, it was because they were elderly and with no carers or doctor on hand to help them at home.

Paul explained that their role over the last twenty years has changed, almost beyond recognition. Yes, they attend real emergencies but they also have to act as community carers because there's no one else to it.

Again, I was surprised. I shouldn't be surprised, I have been told over and over again that A&Es are struggling to cope with pressure because of our aging population, because people can't get a doctor's appointment and because funding for social care has been slashed. I've been told that but only today did I actually see it with my own eyes.

We caught up with Audrey later that evening. She was about to go home, having waited four hours to be seen at A&E and spending the rest of the day in a bay.

I asked her why she had felt the need to call 999. She explained that she'd tried to call NHS 111 but kept being cut off and whenever she tries to get a doctor's appointment she has to wait a week. She knew, she said, if she called 999 someone would come and help her straight away. At this point she started to cry. She didn't want to put anyone out but she didn't have anyone else to help her.

When we left Dan and Peter for the day, they were sitting in a corridor at the Queen Elizabeth hospital in Gateshead. They'd brought in a 62 year old woman with MS who was having severe breathing difficulties. They were trying to book her in and hand her over but had been told there wasn't a bed and they were looking at a two hour wait.

I asked Peter whether this was normal. Yes, he said, at least once or twice a day there'd be a long wait to release a patient because A&E was full. And with a resigned shrug, he said, "usually right at the end of our shift".

Our day with Dan and Peter is a true reflection of what is going on across the country. Hospital after hospital is full up because more and more patients with chronic, complex needs are being brought or taken to hospital.

They don't want or even need to be in A&E but until there is better care in the community or more doctor's appointments they will continue to flood the wards.

Staff at A&E, and indeed the paramedics, are doing everything they can to meet targets and get people in and seen to - I have born witness to that all day.

The problem is the sheer number of people in need. Everyone I met told me there needs to be a complete restructuring of how care is provided in the community and after today, I'm beginning to really see their point.