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More strikes would undermine efforts to cut waiting
lists
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Sustained focus on quality of patient care essential,
say trusts
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Determination to keep improving patient care
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“Most challenging financial year ever” – trust
leader
More strikes, staff burnout and relentlessly rising demand for
care amid a severe funding squeeze could put paid to further
progress in cutting delays for patients, health leaders have
warned.
And many expect this winter will be even tougher than the last,
according to a survey by NHS Providers.
Yet despite huge challenges, the survey showed an undiminished
determination to keep improving patient care, giving them the
right care in the right place. Their commitment to addressing
race and health inequalities remains as strong as ever, with 86%
of trusts surveyed prioritising race equality and tackling
discrimination.
The State of the provider
sector survey provides a yearly snapshot of the hopes
and fears of leaders of hospital, mental health, community and
ambulance services across England.
Without exception they say more industrial action would harm
their ability to hit targets for reducing backlogs and delays in
planned and emergency care, with a knock-on effect for services
right across the NHS.
Money worries continue to mount with more than three in four
trust leaders (76%) saying they are set to be in a worse
financial position than last year. Funding pressures are fuelling
concerns about future patient safety and the quality of care as
well as threatening to hit trusts’ ability to ramp up services as
they brace for winter.
Steps to date to curb costs have included shelving plans for more
beds, having to put on hold recruitment to plug gaps in the
workforce, and reducing investment in community and mental health
facilities.
One hospital leader called the savings targets “completely
unrealistic” while another said that expectations of delivery on
all fronts were “difficult to achieve and sustain" in the current
climate.
There are also worries around the relentless rise in demand for
mental health and learning disability services post-pandemic amid
concerns over the impact of the cost of living crisis.
All of these challenges risk impacting staff morale and quality
of care for patients.
Survey findings include:
- Eight in ten leaders (80%) say this winter will be tougher
than last year (66% said last year was the most challenging they
had ever seen)
- 95% are concerned about the impact of winter pressures
- Most (78%) are worried about having enough capacity to meet
demand over the next 12 months - higher than before the pandemic
in 2019 (61%).
- Most are concerned about the current level of burnout (84%)
and morale (83%) in the workforce.
- Almost nine in 10 (89%) are worried that not enough national
investment is being made in social care in their local area
- Fewer than one in three (30%) think that the quality of
health care they can provide in the next two years will be high.
Sir Hartley, chief executive of NHS
Providers, said:
“These results paint a very concerning picture about the
challenges the health and care sector faces.
“Patient care and safety are front and centre in everything that
trusts do. But the stark reality is that NHS trusts are facing
their toughest test yet.
“As we head into what’s expected to be another gruelling winter,
the spectre of more strike action continues to loom large over
the health service.
“Efforts to bear down on waiting lists – a government priority –
have been hit hard by industrial action. With targets to tackle
record waiting lists already being watered down, any further
walkouts would compromise the NHS’ ability to deliver efforts to
reduce care backlogs and lead to more delays in planned and
emergency care.
“The NHS can’t afford further strikes. Talks between the
government and doctors’ union are promising and it’s absolutely
vital that ministers pull every lever they can to break the
deadlock.
“The major, systemic financial pressures providers continue to
face are adding to trust leaders’ worries alongside widespread
staff shortages with more than 125,000 vacancies in the NHS in
England, and soaring demand for many NHS services.
“The direct costs of hiring temporary cover for striking staff
and the indirect costs of rescheduled appointments and procedures
are having major knock-on consequences for trusts, including
weakening their ability to recover care backlogs for hospitals,
community and mental health services.
“Trusts are having to tighten their belts to find unprecedented
efficiency savings while inflation squeezes already strained
budgets, leaving little in reserve to invest in the extra
capacity they need to deal with winter demand.
“There is palpable frustration at the Treasury’s unwillingness to
provide extra funding to tackle the fallout from nearly a year of
industrial action.
“The consequences of forcing NHS England and the DHSC to raid
their budgets to make up this funding shortfall will be felt far
and wide, putting the core NHS budget under further strain and
much needed projects, including digital transformation, on the
back burner.
“Ultimately, it’s patients who pay the price.
“Despite these multiple challenges, credit must go to trust
leaders and their staff who have reduced the longest waits for
treatment and continue to work flat out to see patients as
quickly as they can.
“Their determination to deliver timely, high-quality care for
patients is unshakeable. Their desire to improve services and
build on the achievements of the NHS is undimmed. They are doing
great work, often in the most difficult circumstances, but it’s
clear that they face their toughest test yet as winter and
budgets bite.”
Ends
Notes to editors
- 185 leaders of 118 trusts, accounting for 56% of the provider
sector, responded to the survey carried out in September and
October 2023.
