Fears that patients are staying away from NHS as A&E attendance falls

There are fears that thousands of people with serious conditions, including cancers and heart complaints, may be staying away from the NHS because of omicron, with A&E attendance at just 80 per cent of expected levels.

Doctors fear the data signals a repeat of the first two lockdowns, when thousands of life saving treatments were missed because people were scared of catching Covid in hospital or of becoming an added burden on the NHS.

“Since omicron was announced the A&E demand is only 80 per cent of expected this time of year,” a senior official told the Telegraph. “We’ve seen this before when cases start to spike whether or not lockdown measures are introduced. People just start to stay away from hospital.

“Of course this can be a positive and negative effect,” the official added. “[It] could be more people self managing minor illnesses, but obviously it’s not good if it’s people who are in serious need of healthcare.”

Data from NHS England showed that A&E visits in April 2020 were 57 per cent lower than the same period in the previous year and were the lowest since records began in 2010. A&E attendance remained lower than average for much of 2020 and only really returned to pre-pandemic levels in the later part of this year.

​​Prof Andrew Goddard, president of the Royal College of Physicians, told the Telegraph that the full scale of missed diagnoses could take a decade to emerge.

“We’re expecting to find lots of cancers presenting late, we’re expecting to find people developing heart failure more, but the signs are very subtle,” he said. “We expect it to be a five or even a 10 year tail to the pandemic of non-Covid disease that might have been caught at an earlier stage.”

Research in the journal Heart estimates that the number of people attending an emergency department for a cardiovascular condition fell by between 31 and 88 per cent during the first lockdown, suggesting a “major burden” of undiagnosed cardiovascular disease.

Similarly, a report from the National Audit Office (NAO) found between 240,000 and 740,000 cancer referrals have been “missed” since the first lockdown, as people have struggled to get appointments with GPs or stayed away from the NHS for fear of Covid or being a burden.

Prof Goddard said that his colleagues in London – the first region to be hard hit by omicron – are already seeing a 20-30 per cent reduction in attendances to A&E.

Some of this drop may be beneficial – in usual times, roughly a third of people who go to A&E could be treated elsewhere. However, it’s too soon to know whether it is this group that represents the fall in attendances.

Prof Goddard, who had to go to A&E himself after a cycling accident on Christmas Eve, added that other patients in the emergency department were “petrified” of catching Covid in hospital as cases surged.

“I think people are scared to come into hospital,” he said. “But also, because people are partying less, if I can put it like that, the trips and falls you’d see from a normally really busy festive period are reduced.”

An intensive care consultant in the north of England said his hospital had also seen A&E attendance drop over the last few weeks.

“A&E has definitely not been as busy as it has been previously. Whether it’s because people are not going out as much and therefore not exposing themselves to potential harm or whether it’s because they just don’t want to come in because they’re scared of getting Covid, I don’t know,” he said.

But doctors also stressed that the NHS is currently under mounting pressure, at a time of year that is always difficult due to a surge in demand and drop in staff over the festive period.

“Hospitals are very very busy [and] it feels worse than a normal winter because of staff sickness,” said Prof Goddard. “Undoubtedly there are more staff absences through Covid reasons… which is making a normally tough time tougher than ever.”

An NHS spokesperson said: “While NHS services remain incredibly busy, with the second busiest November for A&E on record – the NHS is absolutely there for those who need it – and anyone who needs care should continue to come forward through NHS 111 Online so that staff can help signpost you to the best option for you.”

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