Time running out to prepare NHS for another difficult winter, providers warn

NHS Providers has this week stated that “time is running out” for local health services to be made safe to fully protect patients this winter.

Following a torrid winter that was described as one of the most difficult for the health service since records began, NHS Providers’ most recent winter warning update has stated that an immediate cash injection of between £200m and £350m is now needed to properly enable the NHS to manage patient safety risk when the cold bites.

The report, which builds on what the organisation’s Philippa Hentsch wrote about for NHE earlier this year, argued that although planning and support for this winter is already “considerably more developed” than it was last year, there are still a number of factors are outweighing these positive steps.

These include the fact that trusts are not benefiting from the £1bn of extra cash for adult social care announced in the Spring Budget, despite firm promises from government.

NHS Providers also claimed that demand for emergency care is continuing with an “inexorable rise”, key staff shortages are growing and primary and social care capacity as a whole remains very challenged.

“Last winter the health service came under pressure as never before,” said NHS Providers CEO Chris Hopson. “At its height, the NHS had to provide 4,500 additional beds a day – equivalent to more than eight extra hospitals.

“Patient safety was compromised as local services struggled to cope with the pressures. At times, in some places, the NHS was overwhelmed. We must act now to prevent the situation becoming even worse this winter.”

Hopson stressed that trusts are doing all they can to prepare for this winter in the face of increasing demand for services and competing priorities, but even despite this, the overwhelming view of trusts is that without immediate extra funding they will not have sufficient capacity to manage this winter safely.

“This risk has been heightened because, in many areas, the £1bn of extra support for social care announced in the Budget will not ease winter pressures on the NHS, as the government had planned,” the CEO added.

“Patients will therefore be put at greater risk as local trusts won’t have the extra beds, staff and services they need to meet the extra demand they will face. The only way to mitigate these risks is through an urgent NHS cash injection to ensure the NHS has the necessary capacity this winter.”

The organisation has written the update report using the input of frontline NHS trusts and discussions with system leaders, as well as detailed analysis of key performance data such as the four-hour A&E standard and bed occupancy levels.

Painting a worrying local picture, the chief executive of the Colchester Hospital University FT, Nick Hulme, warned that the first quarter of the year had already been as challenging “as any I can remember” and that it was showing no signs of letting up.

“Acuity, attendances and admissions have all stayed high,” he explained. “The planning meetings we have had through our A&E delivery board have been dominated by firefighting rather than looking ahead to the winter.

“Our major concern going into this winter is staffing – going into August we are 50 junior doctors short on our rotas across the hospital. Every day is a constant struggle for junior doctors and registered nurses.”

And John Lawlor, chief executive of Northumberland, Tyne and Wear NHS FT, added: “A significant concern for mental health services is the growing pressures on our ability to sort packages of care so that our patients can be discharged from hospital when they are ready.

“Pressures on staffing, especially in psychiatry, are beginning to impact on services and these will become more intense until the new people trained begin to come on stream over the next 5-10 years.”

And CEO of NHS Confed Niall Dickson also said that the "sombre" report reflected the enourmous pressure being faced by the NHS in England. 

“Last year the NHS managed incredibly well but we cannot continue just to rely on a hope that viruses will not wreak havoc, that the weather will be clement and that staff commitment will get us through," he said.  

“We will continue to push the Government for a comprehensive review looking at which services are needed, where they are needed, how much they will cost, and how they will be funded. 

“As summer fades, the prospect of another difficult winter looms. The challenge lies not just in hospitals - we have shortages of community nurses, GPs, social care services and nursing home places, all of which are vital in taking pressure off the hospitals.”

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