Hospital chiefs have warned that patient safety will be put at risk this winter if the NHS does not receive a £350 million emergency bailout.
As the NHS faces up to another tough winter, NHS Providers, the organisation that represents 97% of hospital, mental health, community and ambulance service Trusts in England, is calling for an immediate emergency cash injection of between £200 and £350 million to enable the NHS to manage patient safety risk this winter.
According to the group, failure to make this investment will lead to lengthening waiting times for patients in A&E and other services and will also put the safety of patients at risk as local Trusts have insufficient capacity to meet extra expected demand. The extra funding is needed to complement other work currently being undertaken to improve the NHS’ state of readiness for this winter.
In a new report, NHS Providers gives its latest assessment of the state of play on planning for what is currently heading for a worse winter than last year – widely regarded as the worst winter for the NHS in recent times.
The report finds that the level of planning and support for this winter – led jointly by NHS England and NHS Improvement – is considerably more developed than last year and emergency care performance has been given greater priority. Extra social care funding is helping to increase capacity in about a third of local areas and this should help to reduce the delays faced by some patients in those areas when they are medically fit to leave hospital but unable to do so because of a lack of available support in the community. Local trusts and systems are also putting huge efforts into early resilience planning to ensure patients are protected and face fewer delays.
However, these improvements are being outweighed by a combination of increasing risks:
- NHS Trusts are not consistently benefiting from the extra £1bn of social care investment announced in the spring Budget, as planned. As a result, delayed transfers of care (DTOCs) for patients remain stubbornly high. The Government was targeting an NHS DTOC rate of 3.5% in September to create the extra capacity the NHS needs. The latest data shows this target will now be missed.
- Demand for emergency care is continuing its inexorable rise, while performance against the four hour A&E standard is no better than it was last year, despite the focus local systems have been giving this.
- Key staff shortages are growing.
- Primary and social care capacity, as a whole, remains very challenged.
- And Trusts are also under greater financial pressure than last year and therefore less able to afford the extra capacity they urgently need.
The upshot is that Trusts do not have sufficient capacity to manage this winter safely. They need an immediate cash injection to manage this growing risk. But this must not be at the expense of existing expenditure on services that are key to winter performance such as primary care, community care, and mental health care.
The chief executive of NHS Providers, Chris Hopson said: “Last winter the health service came under pressure as never before. 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.
“Trusts are doing all they can to prepare for this winter in the face of increasing demand for their services and competing priorities. And they are benefitng from much better national level planning from NHS England and NHS Improvement which is helping to identify and support those local areas that are most at risk.
“The overwhelming view of NHS 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 £1 billion of extra support for social care announced in the Budget will not ease winter pressures on the NHS, as the Government had planned. 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.”
NHS trust leaders have expressed their concerns.
Nick Hulme, chief executive of Colchester Hospital University Foundation NHS Trust, said: “The first quarter of this year has been as challenging as any I can remember – there has been no let up. Acuity, attendances and admissions have all stayed high. 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. 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.”
