08.12.16
Next year will be a ‘crucial test’ for NHS resilience, annual QualityWatch shows
Advances in NHS patient satisfaction could be overturned by funding shortfalls and pressure on services, the Nuffield Trust and Health Foundation have warned as they published their annual QualityWatch report.
The report found that the proportion of patients saying they were treated with dignity and respect in hospital increased from 80% to 84% between 2011 and 2015, and the proportion saying they were fully involved in their care plan rose from 51% to 60%.
There were also improvements in treating hip fractures and strokes, both of which are increasingly common complaints. The number of patients dying within 30 days of being admitted for a hip fracture decreased, and so did the percentage of stroke patients having a brain scan within an hour, although this was still below the target of 50%.
Dr Liz Fisher, the report’s lead author, said: “In the face of considerable pressures, our analysis shows that there are improvements to the quality of healthcare for patients that we should recognise and celebrate. These are even more impressive when understood in the context of growing demand for healthcare and the tightest funding settlement for decades.
“But elsewhere, in areas such as ambulance response times, the news isn’t so good. The next 12 months will prove a crucial test for the resilience of the health service.”
The percentage of Red 1 and Red 2 ambulance calls answered within eight minutes fell to the lowest since the target was introduced in March 2016. In the most recent set of figures, 68.3% of Red 1 calls and 62% of Red 2 calls were answered within the set time, still well below the 75% target. The median waiting time to see a consultant increased from 5.5 to 6.6 weeks between 2012 and 2016.
The performance problems for the NHS come as it struggles to cope with the biggest funding squeeze in its history, with a real-terms funding decrease in 2018-19 and a deficit that could reach £22bn by 2020-21.
Nigel Edwards, chief executive of the Nuffield Trust, said: “The fact that the financial squeeze didn’t immediately affect the quality of patient care reflects the hard work and goodwill of NHS staff.
“But slowing improvement in some areas of quality, combined with longer waiting times and ongoing austerity suggests the NHS is heading for serious problems. It seems likely that a system under such immense pressure will be unable, at some point, in some services, to provide care to the standards that patients and staff alike expect.”
Furthermore, the report showed variation in tackling public health. Five out of 16 public health outcomes were improving, including obesity among 4-5 year olds and alcohol-related hospital admissions.
However, the rate of progress in other areas, such as teenage pregnancy and adult smoking prevalence, had slowed, while rates of STIs and alcohol-related hospital admissions were increasing.
There was similar variety in healthcare-acquired infections. Trust-apportioned MRSA cases began to increase again in 2015-16 after decreasing by 82% since 2008-09. C. difficile rates had reduced, but E. coli had increased by almost a fifth since 2012.
Have you got a story to tell? Would you like to become an NHE columnist? If so, click here.