26.03.15
‘Real risk that patient care will suffer’ as NHS deteriorates under coalition
NHS services in England have deteriorated over the last two years in a way not seen since the early 1990s, according to a new report by a leading health charity.
In the second part of a major assessment of the NHS under the Coalition, the King’s Fund has found that the government will leave office with health services under significant strain and a real risk that patient care will suffer as the NHS heads towards a deficit.
The think tank found that hospitals and other providers are heading for an overspend of more than £800m by the end of this financial year, tipping the NHS as a whole into deficit, marking the first time the health service has overspent since 2005-06.
The report states that all areas of NHS care are feeling the strain, with general practice under huge pressure and concerns being raised about access to mental health services for vulnerable patients.
Target waiting times for A&E, hospital treatment and cancer treatment have all been missed in the last two years, while hospital bed occupancy has increased to “very high” levels and delayed discharges have risen significantly over the past 12 months.
It adds that there are signs that NHS staff are under significant pressure and morale is an increasing cause for concern.
John Appleby, chief economist at The King’s Fund and the lead author of the report, said: “The next government will inherit a health service that has run out of money and is operating at the very edge of its limits. While the NHS has performed well in the face of huge challenges, there is now a real risk that patient care will deteriorate as service and financial pressures become overwhelming.
“More optimistically, with the economy recovering, there could soon be an opportunity to think about public spending choices and the kind of health services we want in a fresh light. Future debate about the NHS should focus not on how parsimonious we need to be but on how generous we want to be.”
The report also finds that the NHS has made some progress in improving efficiency, but that it cannot continue to rely on limiting staff salary increases, reducing the prices paid to hospitals for treatment and cutting management costs to deliver savings.
Looking ahead, it signals that, while further efficiencies can be found, additional funding of £8bn a year by 2020 is the minimum requirement for the NHS to continue to meet patient needs and maintain standards of care.
Rob Webster, chief executive of the NHS Confederation, welcomed the report, adding that there is “no doubt” that the NHS is under huge pressure to meet ever growing demand.
“The report reiterates that additional NHS funding of a minimum of £8bn a year is required by 2020 to meet patient demand and maintain standards of care with significant efficiencies needed. Yet with just 41 days to go until the election, we still do not have agreement across the political parties on this minimum additional funding or a deal for social care which itself faces significant pressures.
“The King’s Fund report also highlights that the NHS cannot continue relying on limiting staff salaries and reducing prices paid to hospitals to make savings. With at least £22 billion efficiency savings planned by 2020, the NHS Confederation remains committed to helping develop and deliver the plans for service change that will ensure these savings are made.”
The Royal College of Nursing believes that the report shows there is much the political parties should “urgently” look at. It also echoed the NHS Confederation that the next government would not be able to rely on squeezing staff pay to deliver savings.
Dr Peter Carter, general secretary of the RCN, said: “While the report shows increases in staff numbers, we are still playing catch up after years of cuts and increasing demand and staff are bearing the brunt. Morale is low, and more and more staff are being made sick with stress because of the intolerable pressure they are under.
“Delayed discharge is the cause of many of the problems in A&E departments, and it is a symptom of a lack of investment in community services. Much has been said about a move from acute to community services, but now it is time for these words to turn to action.”
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