29.11.16
NHS trust leaders warn of ‘much higher level of risk’
The NHS is facing a “much higher level of risk” than it can sustain, NHS Providers has warned as it published a new report which revealed widespread fears about service quality, funding and workforce levels.
The survey covered 172 chairs and chief executives from 136 hospital, mental health, community and ambulance trusts.
The trust leaders surveyed warned that they couldn’t maintain services at their current levels for much longer, with only 30% saying they expected performance against key targets to improve in the next six months and only 10% saying they were confident they could maintain their current quality of services.
Chris Hopson, chief executive of NHS Providers, said: “We need to listen carefully to frontline leaders when they say that the NHS is now running a much higher level of risk.
“We need greater honesty and realism about what can be delivered for the funding and staff capacity that is available. We need a smaller set of key priorities, more support for staff, and a better relationship between trusts, the government and its arm’s length bodies to develop solutions to these challenges.
“We need to recognise that complex transformation will take time when set alongside an increasingly stretching task to deliver high quality patient care day to day. Above all, we need a clear plan on how to close the gap between what the NHS is being asked to deliver and the funding available.”
The latest King’s Fund quarterly monitoring report showed that in the second quarter of this year, 90.6% of A&E patients waited less than four hours to be treated against a 95% target, which NHS trusts are consistently missing. A third of trusts also predict that they will not meet their financial control targets.
Although the number of trusts reporting a deficit is decreasing thanks to strict new financial measures, the NHS Providers survey revealed that almost half of respondents expect their organisation’s financial position to deteriorate in the next six months.
Yet many reported that concerns about staff levels were an even bigger worry than concerns over finances.
Only one in four respondents thought they had the right staff numbers, quality and skills mix, and more expected this to deteriorate. The NHS is facing a staff shortage of almost 6%, which the Public Accounts Committee has attributed partly to government mismanagement.
Nigel Edwards, chief executive of the Nuffield Trust, said the staffing concerns were "very worrying" and reflected the think tank's own research.
"The current combined pressures of increasing patient demand and strained finances are making it very difficult to recruit into areas such as general practice and A&E departments in some parts of the country," he said. "Anecdotally, Brexit is making the problem worse."
Furthermore, NHS Providers found that fewer than one in 10 of their respondents were confident that their local area was transforming quickly enough to provide sustainable care and financial balance.
Several NHS organisations around the country are now publishing their STPs, but Hopson has told MPs that these are at risk of “blowing up” because of financial shortfalls.
NHE contacted the Department of Health and NHS England for a comment, but they did not reply at the time of publication.
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