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NHS performance figures paint ‘extremely worrying picture’

Q3 figures show missed waiting times targets, high deficits and significant staff shortages

Louise Prime

Thursday, 22 February 2018

NHS Improvement has praised NHS staff for their efforts in 'yet again delivering their best' while facing rising demand this winter, and said providers coped well with the extra pressure, even though its chief executive also warned that some providers’ financial position has deteriorated so seriously that it is having to work with them to help them grip their problems. But the BMA said the latest figures ‘paint an extremely worrying picture’ with missed waiting times targets, much greater than anticipated deficits and significant staff shortages.

NHS Improvement said its Quarter 3 (Q3) performance report, released yesterday, shows:

  • Better operational planning ahead of winter: performance against the four-hour A&E standard was 89.5% at the end of December, against 89.6% for the same period last year, which it said, “is testament to better operational planning ahead of winter by the NHS and to the hard work of NHS staff”.
  • Rising demand and high levels of bed occupancy that have affected providers’ ability to admit patients who require planned care; this has been affected by delays in transfers of care to other settings, including social care. During Q3 there were about 470,000 bed days across acute, community and mental health providers occupied by delayed discharge patients (4.6% of all beds).
  • Agency costs have continued to decrease significantly, and despite an increase in bank staff the sector spent £108m less than planned on agency staff, and 20% (£441m) less than the same period last year.
  • A slight reduction in vacancies: workforce data from providers show that they employ 1.1 million whole-time equivalent staff but have 100,000 vacancies. Vacancies have reduced slightly over the last quarter, but the high vacancy rates continue to have an impact on performance.
  • The provider deficit stood at £2.47 billion in 2015-16 and has been reduced through a series of measures including cutting down on expensive agency staff, efficiency measures and smarter procurement.
NHS Improvement said its report shows that providers coped well with the extra pressures and halted the year-on-year decline in A&E performance seen during the same period over the previous four years. Its chief executive Ian Dalton said: ‘‘NHS staff have yet again delivered their best for patients in the face of rising demand…I would like to say my heartfelt thanks to NHS staff for their continued hard work and recognise that there is more hard work ahead.”

But he added: “Some providers appear to have managed the financial pressures better than others. We are working closely with those providers whose financial position has deteriorated seriously to ensure that they grip their problems while delivering the best possible care for their patients.”

The BMA said the figures should act as a wake-up call for the government, and warned that the NHS urgently needs greater funding to halt the decline and put the health service on a sustainable footing for the future.

Council chair Dr Chaand Nagpaul said: “These figures paint an extremely worrying picture, with NHS performance in decline in several key areas. Waiting times targets are not being met, the deficit is much greater than anticipated and there are significant staff shortages.

“It is clear from these figures that the health service just doesn’t have the resource nor capacity to meet rising demand. Without the necessary investment in staff and services the NHS will continue to struggle to meet demand, and current staff will be stretched even more thinly, compounding recruitment and retention problems.”

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