Working as a senior doctor in an A&E department this winter means one very simple thing: providing care to more people than we have the resources or capacity to treat.
It does not require a brain surgeon to work out that we cannot look after you on a trolley in a corridor as well as we could in a specifically designed patient area.
Corridors don’t have the correct equipment and they certainly don’t come with the appropriately trained staff, but corridors are where patients are parked while they wait for beds in the hospital and the emergency room continues to fill.
The numbers will increase as the winter crisis deepens. The cuts to beds, funding and social care, as well as problems recruiting healthcare professionals to staff A&E make this inevitable.
Our only option is to make do and hope.
Hope that in a few days some bed space in the hospital will become available to move you to.
Hope that some patients will be able to get the care they need in the community so that they can be at home.
Hope that, in a few months time, the pressure may ease a little so that we can give patients the attention, the dignity and care that they need.
Hope that Government funding may start to match the resources we need to care for patients’ safely.
Make no mistake, we are appalled by the level of care we can provide.
Our attention, our decision making, our compassion and our energy all have limits and working consistently beyond capacity means mistakes can be made and the care we provide for our patients suffers.
The end of each of my shifts is greeted with relief that it is over; my off-duty is then spent worrying about whether my decisions were correct, whether I missed an infection, a heart attack or a cancer.
No doctor wants to work like this. No patient should have to experience it.
That there are more patients who are older, sicker and more complex is completely predictable.
A few million 70 year olds were not suddenly born in 2015.
When politicians tell you that “demand” is too high or that “too many patients” are presenting to emergency departments, doctors roll their eyes, exasperated at the ministerial hogwash trotted out to excuse the fact that those in charge are failing the healthcare of this country.
The crisis we are facing in our departments could have been prevented if the Government had provided the appropriate resources and planned for it.
This is incredibly frustrating for those of us who work on the front line of the NHS.
We cannot do more with less. We simply cannot.
My patients are angry. I want to tell them that so am I. So are all healthcare workers.
There is no health minister standing in our waiting room apologising for the seven-hour wait.
The corridors of Westminster are not stacked with trolleys of patients waiting for a bed.
And so it is left to doctors like me to assess, care for and treat patients as best we can, alongside apologising for the failings of the health service.
Failings that we have no control over.
And so as well as providing care, I now feel that it is also my job to speak out.