NHS ‘on a knife edge’ as winter care crisis looms, experts warn


The NHS is heading into winter on a knife edge as half of NHS trust finance directors warn patient care in their area has got worse over the past year, an influential think tank has said.

The King’s Fund believes the negative outlook from 51 per cent of finance directors, compared with six per cent who said there had been improvements, is a sign that a seven-year squeeze on NHS and social care budgets is impacting on patient care.

It found that 89.7 per cent of A&E patients were seen within four hours in September compared with 90.6 per cent in September last year.

Overall performance was down, despite a major improvement drive and relaxation of the 18-week referral to treatment target.

The King’s Fund’s new quarterly monitoring report also found that 89.4 per cent of patients waiting for treatment in August had been waiting up to 18 weeks, compared with 90.9 per cent in August last year. The think tank said this is missing the 92 per cent waiting target and that 4.1 million people are now waiting for treatment.

Siva Anandaciva, the King’s Fund’s chief analyst, described the outlook of the finance directors as “sobering” as it suggests NHS funding pressures are having “a real impact”.

He said: “This is happening despite the herculean efforts of staff and NHS leaders working to maintain standards of care under huge pressure.”

An NHS England spokesman insisted the NHS’s “high standards of care have been maintained and in many cases improved”, but admitted this was “in the face of mounting pressures as also set out by the King’s Fund”.

Hospitals are planning to open up more than 3,000 extra beds to cope with demand, and work is under way to free up to 2,500 more by improving the availability of community health and social care, the spokesman added.

It was also noted that councils have been given an extra £1 billion this year to ensure that people who do not need to be in hospital can be cared for closer to home.

Eddie Saville, chief executive of the Hospital Consultants & Specialists Association, said the latest findings will add to deepening concern among hospital doctors about a real-terms decline in NHS pay and extra efficiencies.

He said: “Finance directors are the people tasked with making the sums add up at a local level, so it is revealing that a growing number report declining standards of care amid the efficiencies already being demanded to meet their targets.

“The authors also echo our fears that front-line workforces, despite doing their utmost to improve quality, are being set an ‘unachievable task’.

“NHS staff, including senior grades who have had almost no input into decisions made about care at arm’s length, have now lost confidence in the direction and nature of travel.”

The latest stark warning comes after The Yorkshire Post reported earlier that a bed blocking crisis in the region’s hospitals was stretching the winter care crisis throughout the year, as patients were stuck in hospital for up to five months despite being declared fit to go home, even in the spring and summer. Experts said unnecessary delays were no longer just a seasonal crisis.

“In many areas, winter pressures never really went away,” said Phillippa Hentsch, head of analysis at trade association NHS Providers.

“Urgent decisions have to be made to ensure hospitals, and local health and care systems, have the beds and staff in place to cope with what is widely expected to be a busy winter period.”

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