DOCTORS’ leaders yesterday warned that the NHS in England is unlikely to recover from the pressure it faces during the winter, with trends suggesting that the health system is entering a state of year-round crisis.
New analysis published by the British Medical Association (BMA) shows that last winter was one the worst winters on record, with all key performance markers showing a health system that is struggling to cope with demand.
Bed occupancy, delayed transfers of care and waits at A&E are all increasing, with patients waiting longer for ambulances, treatment and admission. Targets are consistently not being met across the health system. Doctors’ leaders are warning that these trends are only going to worsen.
This was not a particularly challenging winter in terms of external factors – it was a noticeably mild December; in central England the average temperature in January was just 0.2C below the recent historic average. Similarly, there were no widespread outbreaks of influenza or norovirus.
New BMA analysis of NHS performance in England shows that:
• Over the first three months of 2017, bed occupancy on general and acute wards was 91.4% – the highest figure recorded;
• Mental health bed occupancy at the end of the year was 89.7% – also the highest figure recorded;
• There were 328 fewer available mental health beds between January and March than between October and December;
• Between November 2016 and March 2017, almost a fifth of patients waited over four hours to be seen at major A&Es;
• The number of trolley waits in that period also dramatically increased – in 2016/17, over 290,000 patients waited at least four hours to be admitted – an increase of almost 70,000 on the previous year;
• Despite the NHS England target that no patient wait more than 12 hours on a trolley, the number of such incidents has dramatically increased over the past seven years, from 37 in the winter of 2010/11 to 2,337 last winter – an increase of 6,831 per cent;
• Between the start of December 2016 and the middle of March 2017, 94 of 152 trusts issued major alerts on at least one day to say they couldn’t cope. Two-thirds of the most serious alerts were issued by just 10 trusts;
• From November 2016 to March 2017 there were, on average, 6,708 patients experiencing a delayed transfer of care on any one day.
The startling new analysis has been published in the run-up to the general election where the BMA is calling on politicians to address the pressures across the healthcare system that prevent the delivery of high-quality, safe care by:
• Investing in the medical workforce to attract and keep the doctors we need;
• Prioritising high-quality training and education for doctors at every stage of a medical career;
• Agreeing a long-term solution to the funding, capacity and staffing challenges overwhelming the health and social care systems;
• Ending repeated breaches of safe levels of bed occupancy and work with local government to reduce the impact of pressures in social care on hospitals.