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Heatwave pressures on ‘broken’ NHS to continue after temperature drops, top doctors warn

Risk from dying during heatwave is greater for those with severe mental illness, leading doctors warn

Rebecca Thomas
Health Correspondent
Tuesday 19 July 2022 10:13 EDT
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Heatwave driven pressures on the NHS will grow in the coming days even after the temperature drops, doctors have warned.

Doctors speaking with The Independent have described pressures on A&E as the “worst they’ve ever seen it” warning services are “broken, not breaking, not under strain, broken””

It comes as top medical journals in the UK have warned the government “at no other time in the past 50 years have so many parts of the NHS been so close to ceasing to function effectively.”

Leading doctors for working Equally Well UK, a group of dozens of health organisations focussed on improving physical health of those with mental illness, have warned the heatwave will have a greater risk for people with severe mental illness.

Dr Wendy Burn, clinical chair for Equally Well and former Royal College of Psychiatrists president told The Independent: “A heat wave increases the risk of dying for the whole population but this risk is greater for people with severe mental illness such as schizophrenia or bipolar disorder.

“People with these illnesses sometimes do not recognise when they are becoming overheated, in addition antipsychotic medication can cause problems with the body’s ability to regulate its temperature. For patients taking lithium dehydration will increase lithium levels, this puts them at risk of dangerous toxicity.”

Psychiatrist Dr Dolly Sud also warned “photosensitivity” is a particular problem associated with the antipsychotic chlorpromazine.

They said: “It is important that these patients are advised about their sensitivity to heat and how to keep cool and stay hydrated.”

In a comment on the current pressures facing NHS service to the Independent, Dr Susan Crossland, immediate past president of the Society for Acute Medicine, said:“Colleagues across the country have had extremely difficult weekends and urgent and emergency care remains under great pressure.

“It is likely heat-related issues will start to filter through in larger numbers from [tonight] onwards for a few days even after the temperature drops.”

A spokesperson for the Medicines and Healthcare products Regulatory Agency said: “For some medicines such as lithium and other antipsychotics it is particularly important that patients drink enough fluids and do not become dehydrated. Patients should be aware that their lithium levels may need to be monitored and that a change in their eating and drinking habits may require an adjustment in the lithium dosage.”

Speaking with The Independent clinicians and healthcare across the county have warned of how bad pressures had already become in the last week.

A senior doctor in the Midlands told The Independent the situation “is the worst I’ve ever seen it and I honestly believe that the emergency care system has collapsed.

“People are coming to harm, daily stories of elderly, in particular, suffering avoidable injury due to ‘long lies’ waiting for ambulances”

One doctor in the North East said: “I think it could only be described as broken, not breaking, not under strain, broken.”

Another said: “Waiting times are escalating with clear dangers to patients. The health service has collapsed. All around me is chaos.

“The staff are stressed and desperate I can see no easy way out of this mess, it will take decades to rebuild, and it cannot be done without the sort of generational impetus that the people who lived through the 1930s depression and world war two had.”

Their warnings come as hospitals across the country were told by NHS England to create more bed space in order to help offload patients from ambulances more quickly as the sector hit its highest level of alert.

The British Medical Journal’s editor Kamaran Abbasi and Health Service Journal editor Alastair Mclellen have called on the government to return to mask hearing in healthcare settings, public transport and to reintroduce free tests for the public.

On Monday they wrote: “The heart of the problem is the failure to recognise that the pandemic is far from over and that a return to some of the measures taken in the past two years is needed.

…Above all, the government must stop gaslighting the public and be honest about the threat the pandemic still poses to them and the NHS. Being honest with the public will have two positive results, it will encourage the public to modify behaviour and, we hope, provoke urgent reflection about how the NHS is in such a mess so soon after the nation was applauding it on their doorsteps.”

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