Time is running out for local health services to be given the extra funding and capacity they need to fully protect patients this winter, according to NHS Providers.
The organisation, which represents 97% of hospital, mental health, community and ambulance service trusts in England, is calling for an immediate emergency cash injection of between £200m and £350m to enable the NHS to manage patient safety risk this winter, in addition to the extra £1bn of social care investment announced in the Spring Budget.
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. The report has been informed by regular feedback from frontline NHS trusts and discussions with system leaders, as well as analysis of the latest data on key performance targets such as the four hour A&E standard and bed occupancy levels. It follows an earlier report on winter planning published by the organisation in June.
The report finds that extra social care funding is helping to increase capacity in about a third of local areas, which should help to reduce delayed transfers of care. 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 benefitting from the extra £1bn of social care investment announced in the spring Budget, as planned. As a result, delayed transfers of care for patients remain stubbornly high. The Government was targeting an NHS delayed transfers of care 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 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.
- Trusts are under greater financial pressure than last year and therefore less able to afford the extra capacity they urgently need.
NHS Providers says the decision needs to be made immediately to ensure trusts have the time to put in place extra capacity in community, ambulance and mental health services as well as in hospitals, and to help pay for more doctors, nurses and care home staff. Failure to ensure this will result in extra money being spent later in the year on short-term agency staffing fees.
The Chief Executive of NHS Providers, Chris Hopson said, '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 benefiting 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.
'But despite this, 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 £1bn 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.'
Nick Hulme, chief executive of Colchester Hospital University Foundation NHS Trust said, 'We are seeing a mixed response from the local authorities in our area in terms of them using the extra social care funding to help reduce delayed transfers of care. One of our local authorities has taken a pragmatic approach and is passing almost all of the additional funding to a local alliance contract of acute, community and social care providers. However, this hasn’t been forthcoming with another of our local authorities and we have seen very little that convinces me that delayed transfers of care will reduce there.'
Niall Dickson, Chief Executive of the NHS Confederation said, 'This sombre report reflects the enormous pressure currently being faced by the NHS in England. As it makes clear, NHS Trusts are likely to struggle this winter - the truth is that the whole system, including those who commission care, as well as those who provide both health and care services are facing very difficult choices.
'We will continue to push the Government for a comprehensive review looking at which services are needed, where they are needed, how much they will cost, and how they will be funded.
'As summer fades, the prospect of another difficult winter looms. The challenge lies not just in hospitals - we have shortages of community nurses, GPs, social care services and nursing home places, all of which are vital in taking pressure off the hospitals.'
Read the full report on the NHS Providers website.