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NHS facing year-round crisis and cannot cope, warns BMA

Frontline NHS services buckling under strain of relentless demand with staff under unremitting pressure

Louise Prime

Friday, 13 September 2019

The latest NHS performance figures reinforce the difficult truth that frontline health services are buckling under the strain of relentless demand and NHS staff are coming under unremitting pressure, the NHS Confederation has warned. The British Medical Association said the figures provide the “clearest evidence yet that the NHS cannot cope with the year-round crisis it is now facing”, and called on the government to take urgent action to resolve the crises of doctors’ pensions and tax as these add to the problem by forcing doctors to reduce their working hours.

The performance figures, published yesterday, reveal that August had the highest-ever recorded figures for A&E attendance, although slightly lower than those for July, as well as the lowest ever proportion of patients treated within 18 weeks of referral. However, the 31-day cancer standard was met.

The data reveal that:

  • There were 2.13 million A&E attendances in August 2019, 6.4% more than in August 2018; attendances in the past 12 months were 3.9% higher than the preceding 12-month period.
  • There were 529,231 emergency admissions in August 2019, 2.3% more than in August 2018; admissions in the past 12 months period were up 5.0% on the preceding 12-month period.
  • 56,499 A&E patients waited more than four hours from decision to admit to admission (40.5% higher than August 2018); of these, 372 patients waited more than 12 hours (129.6% higher than in August 2018).
  • There were 139,903 delayed transfer of care days in July 2019, compared with 140,938 in July 2018 – a decrease of 0.7% – mainly down to patients awaiting a home care package.
  • The number of patients on the waiting list who were waiting less than 18 weeks increased between July 2018 and July 2019 from 3.6m to 3.8m, and the number waiting more than 18 weeks rose from 504,000 to 620,000; 1,032 patients were waiting more than 52 weeks, compared with 3,464 in July 2018, but 532 patients in July 2014.
  • More than 2.0 million diagnostic tests were undertaken in July 2019, an increase of 5.9% on the previous year; 3.5% of patients waiting for one of the 15 key diagnostic tests at the end of July 2019 had been waiting six weeks or longer from referral, against an operational standard of less than 1%.
  • 90.9% of people in July 2019 were seen by a specialist within two weeks of an urgent GP referral for suspected cancer, compared with 91.9% at the end of July 2018; the operational standard is 93%.

Nick Ville, director of membership and policy at the NHS Confederation, commented: “These figures reinforce a difficult truth – frontline health services are buckling under the strain of relentless demand and our staff are coming under unremitting pressure. …

“This summer has piled on further pressure, rather than providing an opportunity for local services to make inroads into reducing waiting times. With A&E attendances on the rise again, up 6.4% year-on-year, and a waiting list of 4.4 million, we are heading into the traditionally busier winter months in worse shape than we would have liked.

“Sadly, this is the new normal. … we are in a dire position.”

NHS Providers said that the figures highlight how hard trusts are working to stabilise performance, despite more people accessing emergency care. Its director of policy and strategy Miriam Deakin said: “With winter coming up, these figures are a concern. This is because in the past trusts have been able to improve performance during the summer months, but as these figures show, that just hasn’t been possible this year.

“The likelihood is that this winter will be a very testing time for trusts. We anticipate that performance will slip even further, with patients waiting longer for treatment across various services.”

The BMA agreed that the new figures are “extremely worrying”. Deputy chair of the BMA Consultants Committee, Dr Helen Fidler, said they are “the clearest evidence yet that the NHS cannot cope with the year-round crisis it is now facing” as A&E departments had their busiest August on record and waiting lists rose to their highest levels.

She said: “The impact of the doctors’ pension crisis and slow pace of necessary tax reform which has forced hundreds of doctors to reduce their working hours, has and will continue to be keenly felt while a no-deal Brexit only threatens to exacerbate the situation and pile even more pressure on the overworked NHS staff.

“The Government’s recent spending commitment for the NHS was seriously underwhelming and based on these figures significantly more investment is needed.

“It is also vital that the Government, having just launched a new pensions consultation, moves quickly to resolve this matter, otherwise, with the NHS being constantly pushed beyond its limits, it is the patients who will be the ones to ultimately suffer.”

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