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30.01.17

Providers demand formal winter pressures review by April

NHS Providers has called for NHS Improvement and NHS England to lead an urgent review into how hospitals account for winter pressures following the health service’s struggles this winter.

New data from NHS England highlighted the scale of the issue as NHS England’s winter operational update for the week ending 22 January showed that demand remains historically high.

While trusts look to experience fewer serious operational pressures as predicted with the worst of winter having passed, the figures show that A&E attendances and admissions were marginally up on the previous week and hospital bed occupancy rates remain well above safe levels.

NHS Providers has called for the review to finish no later than the end of April 2017, with frontline trusts and expert organisations expected to be involved in the process and for the results to be made public.

“The last few weeks have shown that the NHS needs a new approach to managing winter pressures,” said its chief executive, Chris Hopson. “The current situation is unsustainable and the NHS has to do something different next year.

“The time to start planning for that new approach is now, with a formal review of what needs to change.”

Hopson said that while the NHS has “just about managed” this year’s winter pressures in the face of unprecedented demand, it has been a “close run thing” with trusts failing to cope for short periods of time.

This winter has shown some of the worst performance figures against the four-hour target, leading health secretary Jeremy Hunt to consider downgrading the target to only apply to ‘urgent’ cases. Staff have also been overworked as over 68 trusts declared operational pressures mid-way through the month, 61 in one day.

A review by the King’s Fund of the NHS’s mid-winter performance found no such leap in operational pressures last year, saying that it is only down to the “extensive preparation” of NHS staff that the impact of increased demand on the health service has not been worse.

“We cannot carry on trying to manage well known winter pressures in this way,” Hopson said, while thanking staff who have gone beyond the call of duty. “Trusts tell us their resilience and ability to cope with these pressures is diminishing year by year and that their ability to consistently provide the right quality of care, safely, is now being compromised.”

Among the considerations NHS Providers has suggested for the review include how effectively the health service prepared for the winter, and whether it should revert to specific winter funding after a recent change mainstreamed it into the overall NHS budget.

The trust representation body also said that the review should ask how GP access can be extended over the holiday period and what short-term measures can be taken to prepare staff for next year.

Dr Sarah Wollaston, chair of the Health Select Committee, agreed with NHS Providers’ call for an urgent review, drawing attention to the committee’s report on winter pressures last November which called for a similar measure along with a swift boost to adult social care funding.

“The ongoing crisis in social care is undermining the ability of hospitals to respond to winter pressures,” Dr Wollaston said. “We also recognise the importance of community rehabilitation and intermediate care beds in helping to relieve the pressure on acute hospitals.”

Hopson also stressed that any eventual review must recognise the “wider underlying issues” that the NHS must address to improve its performance, including the need for sustainable funding and tackling shortage in certain sections of the workforce.

(Image: c. Rui Vieira)

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