The Health Secretary, Jeremy Hunt, has accepted that the health service in England is facing “completely unacceptable” problems, after a week of negative headlines about NHS performance and pressures.
In an interview with the BBC, Mr Hunt also admitted progress had been “disappointingly slow” in some areas, including integrating health and social care services. The health secretary was speaking at the end of what the national broadcaster dubbed “NHS week”, in which it revealed a major new story each day on the state of the health service.
Patients waiting longer than 18 weeks for routine operations have risen by 163% in four years, with nine out of 10 hospitals experiencing unsafe patient numbers this winter. Other key headlines included record numbers of patients having waited more than four hours for accident and emergency care and question marks over protection from violence for NHS staff. For example, against the target that 95% of A&E patients be treated within four hours, the NHS achieved 86.2% during December. For major A&E departments the figure fell to 79.3%. In addition, delayed transfers of care were close to record levels. There were 195,300 delayed days, and the proportion attributable to social care rose to 36%, according to data from NHS England, which was published in a report on Thursday.
Responding to the A&E figures, NHS Providers chief executive Chris Hopson said: “These figures for December reflect the enormous pressures on the health service as winter started to take hold. “It is worrying that although more patients are being treated, growing numbers of people face delays,” he said. “This is the first time that performance against the four-hour target for major hospital A&Es has dipped below 80%. Delayed discharges are close to record levels. “We have seen powerful coverage in the media this week of the difficulties and distress this causes to patients, their families and carers, because of delays in securing appropriate social care after hospital treatment,” he said. “These types of delays have risen by more than 40% in the last year. Mr Hopson added: “We should not lose sight of how NHS staff have managed to cope in the face of enormous pressure. “The health service is doing more for more people than ever before,” he said. “But despite its best efforts, it cannot keep pace with the additional demands that are being placed on it. “We need an urgent review of how the NHS manages winter pressures so that improvements can be made for patients, as well as staff, next winter,” said Mr Hopson.
Janet Davies, chief executive and general secretary at the Royal College of Nursing, said: “Dedicated nurses and healthcare assistants, the backbone of the NHS, continue to prop up a system that is straining to meet demand. “Nursing staff want to give the best care they can, but there is no easy way to explain to a sick patient why they’ve been waiting on a hospital trolley for 12 hours or more,” she said. “Nurses are being told to discharge patients before they are fit, just to free up beds, and it’s a vicious circle with community health and social care also struggling to cope with demand,” she added.
Meanwhile, Unison head of health Christina McAnea said: “These figures prove that extra resources for the NHS were needed months – if not years – ago. More money isn’t the only answer but, with it, much of the current crisis might have been averted. “The strain on hospital budgets is increasing with every new demand being made of the NHS,” she said. “The government must stop asking trusts to make cuts and instead give the health service a new, much more realistic financial settlement. “A similar injection of cash is needed for social care,” she said. “Without it people well enough to leave hospital but not able to look after themselves will be unable to go home. This only serves to increase the pressure on the NHS.”
On Friday, Mr Hunt responded to the BBC coverage, saying: “We are trying very hard to sort out these problems.” He said tackling social care problems, a recognised reason why so many older patients could not be discharged in a timely manner – was on the government’s policy agenda. “We recognise the pressure’s there. We recognise there is a problem about the sustainability of the social care system,” he said. “That has to be addressed and we are going to do that.” However, the health secretary said he disagreed with some of the BBC’s coverage that suggested the challenges were a “problem unique to the NHS”. He claimed healthcare systems in many countries were “grappling” with similar problems to the UK, because of an ageing population. “There’s no silver bullet,” he told the BBC. He also argued against suggestions that the problems highlighted were all largely due to a lack of funding, noting that France and Germany both spent more than the UK on health but did not do as well as the NHS on a lot of performance measures. Mr Hunt repeated the government line that extra money was being put into the NHS in England – equivalent to nearly £4bn this year.