Since Christmas last year, it was reported that 264 doctors have registered with the General Medical Council (GMC) to work abroad. This comes after experts warned that any cold snap would tip the health service - which is already "a national disaster" - over the edge.

It has reached the stage in which hospitals are under so much strain that they are holding meetings each morning to decide which less urgent operations can be rescheduled or cancelled - usually due to the lack of beds.

Alastair Douglas, former president of the Society for Acute Medicine said the scale of the problem faced this month by the NHS, which employs about 150,000 doctors, was "unprecedented" as these meetings only happen occasionally in a few hospitals once or twice a year and hospitals are so overstretched that urgent operations were being cancelled, even while patients are waiting in theatres.

"There is an element of luck as to whether patients going in for surgery will have their operation or not as there are so many other pressures on the system which makes it impossible to free up beds," he said.

Adults are put into children's wards and specialist hospital day units are being closed down to free up beds. Last week, hospitals ran out of beds on 108 occasions in England alone and GPs have been forced to transport patients to hospitals due to "shocking" ambulance delays.

"Hospitals are faced with an impossible situation," he added.

Difficult to meet previous patient treatment targets

It is particularly concerning as there is an increase in the number of cancer patients having their operations cancelled. Ian Eardley, vice president of the Royal College of Surgeons, said a shortage of beds was one of the causes even though such surgery is usually protected under treatment time guidelines.

Guidelines stipulate that cancer patients should be seen within 31 days and receive primary treatment within 62 days. In November 2016, the 62-day target for treatment to start was missed by 1.5% - only 83.5% of patients being treated instead of 85%.

Mr Eardley said most hospitals were able to see more than 90% of patients within that time period, but in the past year "it's been more difficult to achieve that".

"The NHS is under tremendous pressure - more and more patients are going to A&E and there is more difficulty in getting patients home, and it's not something we are comfortable with at all. If we could get patients home more quickly and effectively, we could carry on with doing surgery more quickly and more effectively," Mr Eardley added.

He suggested that arranging care in the community would be "the easiest thing to do most quickly, although there are other longer-term problems and there also needs to be a broader review of the NHS."

The NHS said it was "pulling out all the stops" to ensure patients receive surgery "as quickly as possible", including hiring doctors from the EU and junior medics from India and Pakistan.

Locum doctors are placing patients at risk

As a temporary solution, locum doctors have been hired but it is reported that more than 8,000 highly paid locum doctors could be putting patients at risk by escaping proper competency checks. An investigation for the GMC also found that hospitals have failed to report stand-in medics whose skill levels are unsafe.

All doctors in the UK are required to undergo annual appraisals and revalidate their license to practise every five years. However, this new report finds that for many locums - some of which are paid £155 an hour to make up for the staff shortage in hospitals - this is just a tick-box exercise.

Sir Keith Pearson, who led the review, said hospitals managers would inform locum agencies "please don't send that doctor again", but fail to provide reasons why. Patients also failed to provide honest feedback about doctors, which is a critical part of the relicensing process, for fear of being identified and mistreated.

GPs shoot down suggestion to work seven days a week

Many doctors are only providing 10 pieces of patient feedback a year for their revalidation reviews, Sir Keith said, and doctors are also allowed to select the best comments to be passed on.

"The current methods of gaining patient feedback needs to be looked at," he said, adding that there was "no obvious mechanism" for identifying concern about a doctor's competency.

The British Prime Minister, Theresa May, has also suggested for GPs to work 12-hour shifts seven days a week to help relieve the pressure but has swiftly received backlash as doctors argue it will only affect the quality of care. MIMS

Read more:
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Sources:
http://www.bbc.com/news/health-38630640
http://www.express.co.uk/news/uk/754294/NHS-crisis-doctors-leave-hospital-battle
http://www.itv.com/news/2017-01-14/doctors-reject-theresa-mays-demand-for-gp-surgeries-to-open-seven-days-a-week/
http://www.telegraph.co.uk/news/2017/01/13/hospitals-failing-raise-alarm-sub-standard-locum-doctors/
http://www.bbc.com/news/health-38603478