As it's winter, we are once again inundated with headlines about the impending NHS "disaster". There are no beds, more and more people are turning up at A&E and services simply can't cope. There is, of course, some truth in this. A particularly cold winter or an unusually aggressive strain of influenza can result on unexpected pressure on health-care services. That said, services are almost always under more pressure in winter so I'm not sure why the press jump on this like it's a new phenomenon.
As the pressure on health-care services mounts, people naturally start looking for "quick fixes" in order to relieve this. Recently, there has been a lot of talk about "frequent flyers" - an unpleasant term used to refer to patients who access health-care services more than others. There is a suggestion going around that if these greedy so-and-sos learned to self-manage better, the NHS would be in much better shape.
Although I've only been a qualified doctor for 2 and a half years, I've met a number of so-called frequent flyers. I recall a young girl with cystic fibrosis who I looked after during my respiratory rotation who had multiple admissions during the 4 months I worked there. I'm pretty sure that if she had an option, she wouldn't have been in hospital, but multiple spontaneous pneumothoraces are pretty hard to manage at home. There was a middle-aged gentleman who I met during my gastroenterology job. Despite everyone's best efforts, flares of his inflammatory bowel disease repeatedly landed him in hospital. Now I'm working in paediatrics, I can think of several patients who bounce in and out of hospital. A viral upper respiratory tract infection is generally something that can be managed at home, but if you have a rare metabolic disorder, chronic lung disease or a complex cardiac condition then it can be deadly. I can't think of a single "frequent flyer" who had multiple admissions for any reason other than that they were unlucky enough to have an unpleasant chronic disease.
Yes, keeping frequent flyers out of hospital would definitely relieve pressure on hospitals. Now, if the people who come up with these soundbites could come up with the medical advances required to cure these patients so that they don't need to keep coming in to hospital, then that would be wonderful. I'm pretty sure the patients would appreciate it too. In the meantime, let's stop blaming patients for pressure on our services and look at ways to better deal with increased demand.