Busy hospital waiting room

Health leaders bracing for ‘perfect storm’ of pressures this winter

Health leaders are warning that this winter is expected to be the most challenging on record, as the NHS prepares to battle myriad pressures across the entire health system.

NHS Providers’ annual State of the Providers Sector survey found that the vast majority (85%) of leaders are more concerned about this winter than any other in their NHS careers, with most (86%) also fearing that their trusts will not have the capacity to meet the anticipated demand over the next 12 months.

Amongst the 183 leaders that responded to the survey, one chief executive said that the high-quality services we’ve grown accustomed to with the NHS simply “will not be sustained” over the coming months.

The findings come as the health sector faces a spate of different issues, creating what one trust chair described as “a perfect storm” of pressures that could cripple health settings up and down the country.

With the threats of industrial action quickly becoming a reality in many places across the UK, nearly four out of every five (77%) of the respondents reported that they were worried about having enough staff to deliver the quality of care required this winter.

Workforce exhaustion is also a key issue for many health leaders – the lion’s share (93%) of respondents indicated they were concerned about staff ‘burnout’ as demand rises, with 80% also worried about morale.

Finances continue to play on the mind of trust leaders too, with more than four in every five (84%) warning that it is unlikely their trust will end the financial year in a better position than they were the previous year.

And with these issues all coming to a head, less than half (48%) of the responding leaders said their trust were on course to meet the end of year elective recovery goals.

NHS Providers’ interim chief executive, Saffron Cordery, urged that “trust leaders are doing all they can, but there’s only so much they can do” before saying that officials have to “boost the resilience of the NHS” to insulate health and care services for the foreseeable future.

She said: "Winter always piles extra pressure on the NHS and our survey paints a worrying picture for patients, staff and trusts.

"Leaders across the NHS are telling us about demoralised staff and a rise in resignations and retirements. Below-inflation pay awards, increases in the cost of living and wider dissatisfaction mean the health service is on the cusp of a highly challenging winter with a number of healthcare workers now contemplating industrial action alongside nurses.”

She continued: "Our staff have worked incredibly hard to bear down on care backlogs, virtually eliminating two year waits and making real strides on other long delays. But this progress could be thrown off track with patients waiting even longer than they are currently because of the myriad pressures services face.

“Alarm bells should be ringing across Whitehall with warnings from our trust leaders that less than half now expect to meet key end of year elective recovery and cancer targets. We can't go on like this. NHS staff are pulling out all the stops in the face of severe workforce shortages, escalating demand and outdated buildings to give patients high-quality care.”

NHE March/April 2024

NHE March/April 2024

A window into the past, present and future of healthcare leadership.

- Steve Gulati, University of Birmingham 

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In episode 42 of the National Health Executive podcast we were joined by Steve Gulati who is an associate professor at the University of Birmingham as well as director of healthcare leadership at the university’s Health Services Management Centre.