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Too much is being asked of a system being given too little

Performance figures for January attract barrage of criticism from NHS leaders over funding and staffing

Caroline White

Friday, 09 February 2018

Too much is being asked of a system that is being given too little resource to cope, NHS leaders have said in response to another set of alarming NHS performance figures for January, published yesterday by NHS England.

“The scale of what the system is dealing with is without precedent – hospitals had to deal with more than half a million emergency admissions last month, a record and almost seven per cent higher than last year,” said Niall Dickson, chief executive of the NHS Confederation.

“We are asking too much of a system that simply cannot cope – and that means patients suffer. More than 1,000 patients had to wait more than 12 hours to be admitted after staff had decided that was what they needed.

"And, of course, it is not just what we see in emergency departments – the reality is the whole system from family doctors, community services, mental health and social care is not coping – what you see in A&E is the visible tip of a large iceberg.”

Alluding to NHS England’s guidance for next year, which at least didn’t expect the NHS to deliver more than was achieved this year, he warned: “Make no mistake, it will be an immense task just to stabilise the service in the year ahead.”

The only way forward was for better co-operation between hospitals, social services, family doctors, community services as well as better use of the voluntary and private sectors, he suggested.

Dr Chaand Nagpaul, BMA council chair, said: “These figures show that the NHS remains under sustained and extreme pressure despite leaders declaring the crisis to be over.

“The four-hour wait target at major A&Es for January is the second worst on record and we’ve reached new highs for the numbers of patients waiting on trolleys. With some very cold weather recorded in the last week it seems unlikely that these burdens will ease any time soon.”

Behind all the statistics were patients waiting for much needed care and staff working in impossible conditions, he emphasised.

“Doctors have real concerns about the quality and timeliness of care the NHS can deliver, without additional funding. We urgently need the government to provide investment that would deliver the extra beds, staff and services the NHS so desperately needs.”

Richard Murray, director of policy for health think tank, The King’s Fund, said that the proportion of people being seen in four hours in hospital A&E units was now at its lowest level for well over a decade, while the number of patients waiting over 12 hours in A&E departments had reached a new high.

"One of the main reasons for this pressure is an alarmingly sharp rise in emergency admissions, which are 6.8 per cent higher than in January last year. This has given hospitals a near impossible task in coping with demand for their services, so huge credit should go to the staff whose hard work and dedication has ensured a very difficult winter has not been even worse,” he explained.

But he added: “Staff cannot be expected to continue absorbing this pressure indefinitely - a sustainable funding settlement and new workforce strategy is urgently needed."

President of the Royal College of Emergency Medicine, Dr Taj Hassan, described the figures as “thoroughly predictable and preventable.”

“Warnings and recommendations have gone unheeded and the results of this are clear to see and borne out by the data; patients are suffering,” he said.

“Worst ever four-hour performance at major departments; the highest ever number of four-hour delays from decision to admit; the highest ever number of patients waiting over 12 hours; the highest ever number of emergency admissions, all set against the intolerable and unsafe backdrop of 95% average bed occupancy: there is simply nowhere to put patients.”

He continued: “We among many others warned that this winter would be difficult, and staff have continued to work incredibly hard to make the best of a testing situation. Yet despite all of this, instead of seeking actual solutions to these avoidable problems, the only action has been to revise the four-hour performance target downwards; legitimising the unacceptable.

“Patients are quite clearly being made to pay for inadequate resources and continued underfunding. As we have said previously, the extra £350m allocated in the budget – just enough to run the NHS for one day – was too little, too late.

“These figures again make clear that patient safety is at risk and we will need more staff, more beds and more resources for both emergency medicine and social care if we are to merely halt the decline in performance in the mid to long-term.”

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