NHS in crisis: too many patients, not enough money, angry staff

It has been the mildest of starts to the winter and yet the NHS is feeling the strain.

One large teaching hospital told me that on Monday alone they had more than 600 attendances.

And today, NHS England figures show that in September (so not even winter) key targets were missed – again.

The A&E figures show that 93.4 per cent of patients were seen within four hours – the target is 95 per cent. Cancer referrals, ambulance response times and NHS 111 calls were also missed.

While delays in discharging hospital patients have reached record levels.  On the last Thursday of September, more than 5,000 patients were in hospital beds despite being ready for discharge.  This was the worst level since records began in 2010.

This comes off the back of Simon Stevens, NHS England’s chief executive, warning that the  Government pledge of £8bn extra funding by 2020 needed to be frontloaded otherwise the NHS will not cope.

And then Christopher Smallwood, chairman of St George’s University Hospitals NHS Foundation Trust, said NHS finances were in a critical condition and that hospitals faced collapse.

Indeed, the siren warnings are coming thick and fast now from think tanks, NHS executives, trades unions, and royal medical colleges.

In fact, they are coming from everywhere except the Department of Health, which continues to assert (as is its job) that more patients than ever are being treated better than ever.

They also say, and it is true, that winter planning started earlier than ever this year.

But none of that gets away from the fact the NHS is on course for an overspend of £2bn by the end of the financial year, and that most trusts say that there is no slack in the system.

The hope is that the upcoming spending review will bring some relief.  But it may take time for that to filter down.  And there is concern that if the communities and local budget is slashed that will add to NHS woes because social care will be adversely affected.

The knock on of that effect of that is well-documented, with more older people ending up in hospital beds for longer than they need to be – and so it goes round again.

And in the meantime the worst months of winter are still to come and the junior doctors could take industrial action which would involve one day of emergency cover only and two days of all out strike.

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