NHS Providers has warned that industrial action by resident
doctors, planned for later this week, could wipe out NHS
recovery, risking hard-won progress on patient care, safety and
NHS finances.
The annual State of The Provider
Sector survey of leaders from NHS hospitals, mental
health, community and ambulance services has found a growing
proportion of trust leaders reporting high or very high quality
care for patients in their area.
It also highlights a range of steps under way to improve NHS
productivity, with a majority of trust leaders saying they expect
their trusts to meet their financial plan, despite severe
pressures.
There are worries however, that imminent strikes by resident
doctors - with the threat of more to come in December - would
jeopardise these gains, particularly as the NHS heads into what
is expected to be another tough winter.
The scale of the challenges trusts face remains daunting,
including waiting times for patients, rock-bottom workforce
morale and increasing demand for care.
There are particular concerns over the priority and resources
being given to mental health services, including scepticism that
the government understands the scale of the challenge, and its
likely impact on economic growth.
Key findings from the survey include:
- A majority of trust leaders (52%) said the quality of care in
their area was high or very high, up 11 percentage points on last
year and the most positive finding on this indicator going back
to before the pandemic. However the findings also revealed deep
concerns over long waiting times and the need for a “fundamental
shift in approach”.
- Most trust leaders (53%) said they have the right number,
quality and mix of staff. The figure for last year was 40%.
However there were deep concerns about staff burnout (79%),
discrimination towards staff from patients and the public (77%)
and morale (74%).
- Even though the survey was carried out before the British
Medical Association announced a further 5-day stoppage by
resident doctors, nearly two-thirds of trust leaders (64%) were
worried about the potential impact of industrial action.
- Fewer than one-in-ten trust leaders (9%) agreed that
investment in mental health services matched demand. More than
half (60%) said mental health services lacked the capacity to
reduce waits and intervene earlier.
- More than a third of trust leaders (37%) described last
winter as the most challenging of their NHS careers. 67% said
they expected this winter to be tougher. However the survey shows
they are putting in place a range of initiatives to ensure safe,
high quality care.
Responding to the findings, Daniel Elkeles, chief executive of
NHS Providers, said:
“This survey reflects a gathering sense among trust leaders that
at long last, we are turning a corner.
“Nobody for one minute underestimates the scale of the problems
posed by long delays, financial pressures and a relentless rise
in demand for care.
“And it's clear that progress is uneven. Some trusts – through no
fault of their own – have a bigger and steeper hill to
climb.
“It's particularly worrying to see the depth of concern about
mental health services when they've never been needed more.
“Trust leaders want to seize on the opportunities presented by
neighbourhood working for a successful and sustainable NHS.
“But instead of going full throttle shifting care into the
community, we're moving at a glacial pace. We need to get a move
on.
“We see progress on productivity that's being driven by digital
transformation and bearing down on agency costs. There's so much
more that can be delivered through AI, too.
“We see the desire for a well-supported workforce, ready and able
to provide the high quality care patients deserve.
“These are key ingredients to win back public trust in the NHS.
“More strikes now could crush this fragile, hard-won progress,
wiping out a once-in-a-generation opportunity to fix the health
service.
“And just ahead of the budget, let's remember strikes come at a
financial cost. That's money the NHS does not have.
“We're starting to shift the dial. Let's all face forward
together to build the better NHS that patients deserve.”
Ends
Notes to editors:
- This year's State of the Provider Sector survey was online
and open from 22 September to 12 October 2025.
- 172 trust leaders responded from 106 trusts across all
regions of England, accounting for 52% of the provider sector.
- They included leaders from NHS hospital, mental health,
community and ambulance services.
- Nearly 40% were trust chairs or chief executives. Other
executive roles included finance directors, strategy directors
and chief operating officers.
- NHS Providers Annual Conference and Exhibition will be held
in Manchester on Tuesday 11 and Wednesday 12 November 2025.
More information
here.
