This year we celebrate the 70th anniversary of the founding of the NHS. However, as things stand it doesn’t look to like it is going to be such a great year for this most treasured and valued institution. 2018 has begun with reports of a system in ‘crisis’, close to breaking point. Record numbers of patients have had to wait in the back of ambulances as hospitals in England struggle to cope with demand, culminating in the suspension of outpatient appointments and elective surgery for the rest of January – a first in NHS history.
Such a drastic move by the new National Emergency Pressure Panel will not have been made lightly, and even brought about one of the rarest of spectacles in politics – an apology. And not one, but two, with both Theresa May and Jeremy Hunt publicly apologising for the decision. Interestingly though, where Hunt accepted that there are “major pressures”, May instead dismissed the idea that the NHS is in ‘crisis’ saying the health service was the most prepared it had ever been to withstand the rigours of winter – perhaps referring to the £350 million in last year’s Budget allocated NHS trusts to help them plan for winter.
As if straight from the ‘crisis comms handbook’, both appeared sombre and apologetic, but moved quickly to distance themselves away from the actual decision, which was made by NHS England. Labour were quick to turn it around, however, demanding that the government releases extra cash to combat the “appalling winter crisis”.
Winter pressures happen every year, and this is not the first ‘crisis’ experienced by the NHS. This time last year the British Red Cross went as far as to say that the NHS was facing a “humanitarian crisis” after they were called in to support the NHS to help free up much some needed beds, showing that the NHS has long been struggling to meet its increasing and now unprecedented demand.
However, there is definitely more of an edge to this year’s reporting (with patients likening some hospitals to “something out of a war zone”) and indeed the reaction of key health organisations and commentators.
NHS Providers commented that bed occupancy rates were well above 85% capacity before ‘winter’ had even started, making it even harder to ensure safe care, with less resilience in the system to cope with any spikes in demand. The organisation has called for an urgent review of the long-term funding settlement for health and care so that the NHS can sustainably deliver its constitutional standards.
Shadow Health Secretary, Jon Ashworth, also said in an opposition day debate in the House of Commons, “This is not just a winter crisis; it is an all-year-round funding crisis, a year-round staffing crisis, a year-round social care crisis and a year-round health inequality crisis.”
Significantly NHS staff themselves have been vocal throughout the ‘crisis’. In a letter to the Prime Minister, signed by 68 A&E consultants from across England and Wales, they give a stark warning about the “current level of safety compromise” calling it “at times intolerable, despite the best efforts of staff”. They have urged May to consider strategies to reduce overcrowding in A&E departments ‘as a matter of urgency’. This includes a “significant increase” in social care funding allowing patients to be discharged earlier when possible, and a review of the number of hospital beds available for acute care.
It is becoming clear that pressure is on the NHS throughout the year, with the winter months merely seeing the brunt of it. The recent flurry of norovirus and flu has just added to an already fragile system. Around 3,800 people have been admitted to hospitals so far this winter, battling ‘Aussie’ flu, in what some experts are warning could be the worst flu season for years.
With Jeremy Hunt being reinstated as Secretary of State for Health and Social Care in the latest government reshuffle, this expanded remit looks set only to add priorities to his already substantial ‘to do list’. And with there being widespread concern over workforce, mental health and the impact of Brexit on the NHS, as well as meeting A&E targets, there’s no doubt the NHS has a lot to tackle before hitting 70.