December 18, 2019

Just how badly is the NHS struggling?

The December 2019 NHS Performance Statistics have recently been published and demonstrate just how frail the NHS system currently is.

The report clearly highlights how the public are becoming increasingly dependent upon on the NHS, and this dependency is growing at an alarming rate; especially within Accident and Emergency (A&E) departments.

A&E departments struggling to meet targets

Across the NHS there were 2.14 million attendances to A&E in November 2019, an increase of 5.2% when compared with November 2018. This has led to the worst turnaround time for patients in A&E since 2004. Only 81.4% of patients were seen within four hours, which is 13.6% lower than the NHS’s 95% target.

Problems with referrals for treatment

However, the strain on the NHS is not just being felt in A&E departments. At the end of October 2019, the total number of NHS patients who had been referred for treatment and were on waiting lists was 4.6 million, a 5.9% increase when compared with October 2018.

With regards to cancer treatment, 2,349,744 people were seen between October 2018-2019, which demonstrated an increase in appointments by 10.8% when compared with the same previous 12 month period. A consequence of this significant increase is that the number of patients actually starting cancer treatment within 62 days is now at just 77.1%. When compared with the NHS’s operational standard – which specifies that 85% of patients should be treated within this time – it is clear just how great the pressure to see patients is becoming.

Serious – and legitimate - concerns over staffing levels

A separate, and yet related, concern currently facing the NHS is the fact that despite this growing demand for care, that the organisation has an alarming number of vacancies in clinical and care roles.

As of October 2019, there were 43,000 nursing vacancies in the NHS, with more than 100,000 vacancies across the NHS generally as of April 2019. When we compare the notable shortages in staff with the worrying increase in demand for care, it becomes clear just how important it is that the NHS can reduce its staffing crisis.

The NHS has had limited success in doing this. Since June 2017, the NHS has been taking steps to improve its retention of clinical workers in key positions. However this has had limited success.

Since June 2017, the retention programme that is being run internally has seen a reduction in staff turnover from 12.5% to 11.9% amongst nurses. Whilst this is an improvement it suggests that, currently, more than one in ten nurses are looking for work outside of the NHS, and begs the question as to whether the nursing shortage could get worse.

Yet, no significant increase in negligence claims?

Despite these issues, the NHS’s annual report for 2018/2019 suggests that there were only five more clinical negligence claims when compared with the previous year; an increase from 10,673 – 10,678.

Although the number of claims for both years seems high, the NHS has avoided the almost expected trend that, with reduced staff and increased demands for care from new patients, that claims would increase significantly. However we will have to wait and see if this level can be sustained.

The purpose of the NHS is to provide medical care for anyone lucky enough to have access to it. However, it is clear even from this snapshot that it is an organisation that is being limited in its attempts to do this.

With waiting times going up, and in some cases being the worst they have been since 2004, and with the number of vacancies in key clinical roles also increasing, it is clear that something needs to be done soon, before the situation becomes unresolvable. Not only does retention of key staff need to improve, but vacancies for current jobs also have to be filled at an alarming rate if a positive step is to be made.

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