Concern over the State of Care in the NHS - November 2017

With the budget approaching we have a plethora of reports of the acute need for additional funding if the NHS is to continue as we know it.

The target for 92% of patients referred for treatment should receive it within 18 weeks has been assigned low priority since March 2017. It had not been achieved for over a year and controlling hospital deficits has higher priority in the current constrained position.

The Care Quality Commission (CQC) have issued a report on the state of care in the NHS.. It concludes that the majority of care is good but that the system and workforce are at full stretch with numbers of patients and complexity of cases still increasing and future quality is precarious. There has been much improvement, it states, but some services have deteriorated in quality.

As reported by Sky News In a speech in Birmingham, Simon Stevens, the leader of NHS England, warmed that the planned budget for 2018-19 falls well short of what is needed to look after patients and their families at their time of greatest need. Some elective treatments may have to be retrenched or rationed.

Workforce shortages are widely acknowledged and aggravated by the uncertainty and unease created by the Brexit vote. The Royal College of Nursing has called for a "cash injection" to the NHS. It calls for £4billion increase for the NHS and £2.6billion of social care to prevent increasing patient waits, deteriorating quality and rationing of treatment. The report is based on analyses by the Health Foundation, the King's Fund and the Nuffield Trust. We can note that the 1% public sector pay policy whose end has just been announced corresponds to a loss in real income of about 14%.

The Health Foundation has issued a report on the NHS workforce. This shows numbers of nurses and GPs still falling and a big fall in the number of mature people starting nursing courses after the abolition of student bursaries for nursing courses outweighing an increase in 18-19 year-olds joining these courses.

NHS Providers has issued a call for budget funding increases to help the NHS recover to achieve its target standards. It points out that despite best efforts from front-line staff all four key NHS performance targets for A&E, planned operations, ambulance response times and cancer were missed last year for the first time ever. The elective surgery list is now nearing a length last seen in 2007; and trusts are warning they will struggle to recover the 95 per A & E four hour target. In calling for a realistic, prioritised plan for the rest of the parliament, it emphasises that NHS trusts want to meet the constitutional standards placed on the NHS. It also points out that they have improved productivity and made significant savings in recent years, and continue to do so.

The King's Fund has been issued quarterly reports on the state of the NHS for six years. In its latest quarterly report they conclude, "Performance against a number of key indicators is worse than at this time last year, and finances remain precarious despite an emergency funding injection." High levels of flu in the Southern hemisphere give rise to fears that there could be many cases here.