Half of the country’s NHS trusts cannot afford to deliver the services being demanded of them, according to an independent think tank. Now experts are concerned that patients’ treatments will have to be either delayed or cancelled completely.
Deteriorating performance
The findings come from the King’s Fund, an independent charity who conducted a survey asking financial leaders for NHS Trusts and clinical commissioning groups (CCGs) across England for data on their financial health and found a deterioration in many key performance areas:
- Around 2.5 million patients spent longer than four hours in A&E. 27.4% more than the previous year.
- Around 362,000 patients waited over 18 weeks for hospital treatment in March 2017. 17.7% more than the previous year.
- Over 26,000 patients waited longer than 62 days for cancer treatment after urgent referral. 8% more than the previous year.
- Just under 2.25 million bed days were lost because of delays in discharges. 24% more than year before.
The NHS overall managed to reach its target of 90% of all patients being dealt with within four hours. But in major A&E departments the figure was around 85.1%. They are supposed to reach the 90% target by September 2017 but according to the King’s Fund the reality of meeting this is slipping away under financial concerns.
What care, who and how long will it take?
The pressure on spending will now force NHS leaders to make stark decisions. They will need to prioritise what care patients can access and how long they will have to wait. King’s Fund Director of Policy Richard Murray says:
This reinforces the underlying reality that demand for services is continuing to outstrip the rate at which the NHS budget is growing.
Postcode lottery
According to the survey, the financial health of NHS England actually improved overall but the wealth isn’t spread evenly across the board. So while half of the country’s trusts will be in surplus by the end of the year, half of them do not have the budget to meet the demand for services. And as a measure to keep within budget, many trusts will need to delay the treatment – affecting performance even further – or cancel it completely.
In response Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said:
It cannot be fair that patients in half of England will wait longer for certain operations – many in pain and discomfort – as the NHS cuts costs. Some patients won’t get treatment at all as the postcode lottery in care is entrenched.
This is because many trusts rely on additional payments from the Sustainability and Transformation Fund, which may conduct one-off sales of NHS land, as encouraged by the Naylor Report. This fund only makes payouts conditionally when performance targets are met.
Austerity
The King’s Fund is a charity that works to improve health and social care in England and has previously been critical of the Conservative government’s squeeze on finances and of its current manifesto:
The £8 billion in additional funding for the NHS over the next five years does little more than extend the squeeze on finances for another two years and will not be enough to meet rising demand for services and maintain current standards of care. The Conservatives need to be honest with the public about the consequences for patients and their care.
The disparity in treatment between different NHS Trusts across England has often been referred to as a postcode lottery. But within the biggest squeeze in the NHS’s history under Tory austerity, it is difficult to see how that gap will narrow.
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Featured image via 38 Degrees
