Our beloved National Health Service is in the midst of a healthcare crisis but how did it get to this point and who is to blame?
We are in the midst of a healthcare crisis – this is a fact and is completely undeniable. Only last week NHS England ordered hospitals to suspend all ‘non-urgent’ care – resulting in up to 50,000 cancelled operations and many more cancelled appointments.
But, who is to blame?
In the media, I see a multitude of things being blamed for the NHS crisis but as a ‘front-line’ worker the majority of these are nonsensical – health tourism, mass immigration and inappropriate use of services being the most popular.
That doesn’t reflect what I see first hand.
Waiting rooms in accident and emergency departments and GP surgeries are not filled with migrants who are only here to take advantage of NHS services, I’ve never met a single patient who has traveled to the UK simply to access healthcare and the majority of patients need to be in hospital – after all isn’t that why we admit people.
These are the real challenges facing the NHS at the moment…
Chronic and severe underfunding of NHS services.
Simon Stevens, Head of NHS England, in November 2017, asked the government for £10 billion to help tackle the chronic underfunding in the NHS, however, Phillip Hammond claimed that his figures were ‘exaggerated’ – providing just £4 billion by 2020 in the budget.
NHS trusts are being forced year-on-year to make ‘efficiency’ savings forcing nearly half (47%) of NHS trusts and a quarter (23%) of clinical commissioning groups to forecast end-of-year deficits with some of the best trusts in the UK being placed in ‘financial special measures’.
Increased demand for services but fewer beds.
The NHS has seen demand for some services increase by up to 300% but staffing and funding have not been increased proportionally.
Despite a rise in demand for service, the total number of NHS hospital beds in England, including general and acute, mental illness, learning disability, maternity and day-only beds, has more than halved over the past 30 years, from around 299,000 to 142,000, while the number of patients treated has increased significantly.
According to the King’s Fund, there are signs of a growing shortage of beds. In 2016/17, overnight general and acute bed occupancy averaged 90.3 percent, and regularly exceeded 95 percent in winter, well above the level many consider safe.
In 2016/17, 23 million patient attended A&E departments compared with 19 million in 2008/09 with an increase in admissions of 65% during the same period – an average increase of 4.3 percent per year.
In January 2017, the Red Cross declared a ‘Humanitarian Crisis’ in NHS Hospitals with the charity’s Chief Executive, Mike Adamson, saying extra cash was needed for health and social care to make the system sustainable.
Rota gaps and vacancies are going unfilled – almost indefinitely.
Research suggests that the NHS is short of around 100,000 doctors, nurses and healthcare support workers and earlier this year the Royal College of Nursing stated that staff were ‘working on the edge of safety’ after it’s members raised concerns over the quality of care they were being able to provide.
UCAS applications for nursing degrees have fallen a spectacular 32% in just two years and, previously over-subscribed, medicine courses are now regularly available through UCAS clearing.
The government are turning to schemes like nursing associates and physicians associates to bring staff into the health service quickly.
But, with ongoing pay restraint and healthcare staff using food banks on a regular basis how can we attract more people into the profession and fill these gaps?
We have seen many examples of private organisations being awarded NHS contracts then failing to provide an adequate while – which at the same time waiting away with huge profits.
In January 2015, Circle said soaring patient numbers made running Hinchingbrooke hospital ‘no longer sustainable’ after a damning letter from the Care Quality Commission had warned of hygiene failures, staffing problems and “a blame approach”
In June 2015, Interserve was issued with a compliance notice ending a £300 million contract with University Hospitals Leicester NHS Trust and forcing them to reverse the changes, after complaints about a decline in services and significant job losses.
In February 2017, Nottingham University Hospitals NHS Trust (NUH) and Carillion have mutually agreed to a managed exit from the core aspects of the Estates and Facilities contract after allegations of poor hygiene in Carillion maintained wards – claims the firm has denied.
So, who is really to blame?