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NHS Under Strain And In The Red

Thursday, March 26, 2015

Health Services Under Significant Strain And A Real Risk That Patient Care Will Suffer As NHS Heads Towards Deficit Says Kings Fund Report

Report points to targets missed for waits for A&E, cancer treatment and admission to hospital, more NHS trusts in the red, and a host of other indicators of a system under strain says GMB.

GMB, the union for NHS staff, commented on a major assessment of the NHS under the coalition government published by the Kings Fund saying it will leave office with health services under significant strain and a real risk that patient care will suffer as the NHS heads towards a deficit. See notes to editors for press release from the Kings Fund dated 26th March 2015.

Rehana Azam, GMB National Officer for NHS, said “The electorate will heed this assessment that the NHS performance is deteriorating and the service is in the red as election approaches.

The Kings Fund highlights the serious consequences of Tory and Lib Dem mismanagement of the NHS. It makes crystal clear that the government’s chaotic reorganisation has added to the pressures the NHS is now facing. David Cameron’s Health and Social Care Act was a purely ideological vehicle for marketising the NHS. The health service will not recover until this pernicious piece of legislation is scrapped.

Only this government could be unaware of the growing NHS crisis. The Kings Fund plainly states that many hospitals are operating at the limits of their capacity. It points to targets missed for waits for A&E, cancer treatment and admission to hospital, to more and more NHS trusts falling into the red, and a host of other indicators of a system under strain.

Another part of the problem is under-funding. The Kings Fund makes the important point that workforce numbers have failed to keep pace with population growth and other demographic changes, most notably the rising elderly population. It warns the service is facing an accelerating decline.

These pressures are having a damaging effect on staff morale and between 2010 and 2014 the number of NHS workers off work ill with work-related stress has jumped.

The NHS is now in a critical condition. This is going to be a massive issue at the general election. People will be voting to protect the NHS.

David Cameron and Nick Clegg had no mandate to tear up the NHS and voters won’t trust them with it again."


Contact: Rehana Azam, GMB National Officer on 07841 181656 or GMB Regional Officers:

Birmingham & West Midands Pauline Hinks on 07809 617 761, London & East of England Tony Hughes on 07738 958 142 or Steve Sweeney on 07703 469403, East Midlands, Les Dobbs on 07966 327 967, North East and Cumbria, Chris Jukes on 07870 176 733, North West, Lisa Ryan 07703 468 968 or Maria Almond 07718 113110, Northern Ireland, Michael Mulholland on 07974 018 413, South East, Nick Day on 07717 510 047, Wales & South West, Paul Gage on 07980 753 117 and Yorkshire, Joan Keane on 07958 156841 or GMB Press Office: 07921 289880 or 07974 251823.

Notes to editors

Kings Fund press release dated 26th March.

NHS performance deteriorating as election approaches, concludes assessment by The King’s Fund

The coalition government will leave office with health services under significant strain and a real risk that patient care will suffer as the NHS heads towards a deficit, according to a major assessment of the NHS under the coalition published by the Kings Fund.

The report is the second in a two-part assessment of the coalition’s record on the NHS, the first part which looked at government reforms, concluding that the upheaval caused by the Health and Social Care Act was damaging and distracting. This new report assesses NHS performance under the coalition, finding that it held up well for the first three years of the parliament but has now deteriorated, with waiting times at their highest levels for a number of years and several key targets missed.

The report finds that the coalition has met its pledge to increase the NHS budget in real terms, with funding increasing by an average of 0.8 per cent a year in real terms over the parliament. Key findings include:

the numbers of doctors and nurses have increased, while management costs have been significantly reduced (1)

patient experience remains positive, while public satisfaction with the NHS is at its second highest level ever (2)

the number of health-care acquired infections has fallen, with cases of MRSA and C difficile at historically low levels (3).

However, with hospitals and other providers of care now overspending their budgets by more than £800 million, the report concludes that the NHS is likely to record a substantial deficit in the final year under the coalition. It finds that all areas of NHS care are feeling the strain, with general practice under huge pressure and concerns being raised about access to mental health services for vulnerable patients. Other findings include:

target waiting times for A&E, hospital treatment and cancer treatment have all been missed towards the end of the parliament (4)

hospital bed occupancy has increased to very high levels and delayed discharges have risen significantly over the past 12 months (5)

there are signs that NHS staff are under significant pressure and morale is an increasing cause for concern (6).

The report also finds that the NHS has made some progress in improving efficiency, but that it cannot continue to rely on limiting staff salary increases, reducing the prices paid to hospitals for treatment and cutting management costs to deliver savings. Looking ahead, it signals that, while further efficiencies can be found, additional funding of £8 billion a year by 2020 is the minimum requirement for the NHS to continue to meet patient needs and maintain standards of care.

John Appleby, Chief Economist at The King’s Fund and the lead author of the report, said: ‘The next government will inherit a health service that has run out of money and is operating at the very edge of its limits. While the NHS has performed well in the face of huge challenges, there is now a real risk that patient care will deteriorate as service and financial pressures become overwhelming.

‘More optimistically, with the economy recovering, there could soon be an opportunity to think about public spending choices and the kind of health services we want in a fresh light. Future debate about the NHS should focus not on how parsimonious we need to be but on how generous we want to be.’

Notes to editors:

The NHS under the coalition government – part two NHS performance is published by The King’s Fund on 26 March 2015. For further information or to request an interview, please contact the Press and Public Affairs team on 020 7307 2585 (if calling out of hours, please ring 07584 146035).

(1) Between May 2010 and November 2014, the number of nurses increased by 2.3 per cent (7,049 FTE) and the number of consultants by 16 per cent (5,568 FTE). At the same time the number of management staff reduced by 16 per cent (6,814 FTE). From 2010 to 2013 inclusive, the number of GPs increased by 0.6 per cent (209 FTE).

(2) A number of patient surveys show that patient experience remains high and is improving across many services. Public satisfaction with the NHS increased to 65 per cent in 2014, its second highest level ever, having fallen from 70 per cent in 2010 to 58 per cent in 2011.

(3) Cases of MRSA and C difficile had decreased significantly before the coalition took office and have continued to fall to 34 and 445 respectively in January 2015. This compares to 59 and 1,019 in May 2010.

(4) In the third quarter of 2014/15, 7.4 per cent of patients spent longer than four hours in A&E. This is up from 2 per cent in the final quarter before the coalition came into office and is the poorest performance since 2003.
11.3 per cent of inpatients and 5 per cent of outpatients waited longer than 18 weeks for treatment in January 2015. This compares to 7.1 per cent and 1.8 per cent respectively in May 2010. The targets for both have been breached in recent months for the first time since 2008.

The target that 85 per cent of patients with suspected cancer should be treated within 62 days has been missed for four consecutive quarters, having never previously been missed since it was introduced at the end of 2008/9.

(5) Occupancy rates for general and acute beds in hospitals increased to 89.5 per cent in the third quarter of 2014/15, up from 87.7 per cent in the same quarter in 2010/11, with one in six trusts reporting occupancy levels above 95 per cent. Occupancy rates above 85 per cent are generally considered likely to lead to bed shortages and expose patients to risks.

(6) 38 per cent of staff reported that they had felt unwell due to work-related stress according to the 2014 NHS Staff Survey. Staff morale has topped the list of concerns raised by trust finance directors in the regular survey undertaken for our last two quarterly monitoring reports.

The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.


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