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HEALTHCARE DELIVERY
hospitals and, ultimately, to patient safety. “What is more, the NHS has gone into winter this year in an even worse position than it was a year ago, with record deficits, worse performance against the A&E target, far more trolley waits, record delayed discharges from hospital, and fewer people getting the help they need with social care. When you add into that mix the sort of intense pressure on beds we’ve demonstrated hospitals experienced last winter, patient care is bound to suffer.” Commenting on the Nuffield Trust’s
report, Mr Ian Eardley, a consultant urological surgeon and vice president of the Royal College of Surgeons, said: “Recently published statistics show that NHS bed occupancy rates are at the highest level they have been for 16 years. This is due in part to underfunding in social care and problems with discharging elderly and frail patients. “A shortage of beds puts hospitals and frontline staff under huge pressure, often leading to patients’ planned operations being cancelled to make vital space available for emergency patients. This can be very distressing for patients and their families who have prepared for an operation. “We also know that increased bed occupancy rates can make it more difficult for staff to control hospital-acquired infection rates such as for MRSA and C. difficile - and make it harder to keep wards clean. “The announcement that councils can bring forward tax rises of 3% in April and a
'Quality of care threatened'
Members of the Council of the Royal College of Physicians (RCP) have written to the Prime Minister, Theresa May MP, to set out their concerns about the capacity and resources needed to meet the demands on the NHS. The letter was signed by RCP president Professor Jane Dacre and 49 members of Council, representing 33,000 doctors across 30 specialties as well as 750 physician associates.
The signatories are fully committed to the NHS and want to work with the government to build on the health service's achievements. However, they say in their letter that the increase in patient need is
further 3% in 2018 to fund social care, could help to slightly alleviate some of the pressure on hospitals. However, this will only happen if social care services significantly improve and elderly patients are able to be discharged from hospital with appropriate care arranged for them at home and in the community, so they can continue their recovery.” Without this, the outlook remains bleak, he concluded. Commenting on winter pressures on the health and care system, Stephen Dalton, chief executive of the NHS Confederation, said: “Pressure on A&E departments is being caused by a lack of funding in primary,
The average number of extra beds brought into service on any given day last winter was 3,466 equivalent to at least five and a half extra hospitals’-worth of beds.
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outpacing the resources available, that services are “too often paralysed by spiralling demand to transform and modernise”, hospitals are “over-full, with too few qualified staff” and services are “struggling or failing to cope”, and there are “increasing reports of staff contemplating the sad decision to leave the NHS”.
The Council members say that “current investment levels are not sufficient to meet current or future patient needs” and the immediate actions needed are “the reinvigoration of social care services and urgent capital investment in infrastructure”.
community, mental health and social care. Health and care staff on the frontline are working harder than ever this winter and are continuing to ‘just about cope’, but this is simply not sustainable. “We have been issuing warnings of the system approaching a tipping point for some time, but we are now starting to see proof that this point has been reached. The government must accept that limited investment at a time of increased demand has consequences. While broad public health programmes have their place, only further and quicker government intervention can fix the imbalance in services that is at the root of this crisis. We are also calling for an urgent cross-party process to inform public debate on funding and structures, setting out a plan for the long-term sustainability of the health and care system.”
King’s Fund report Further analysis3
from The King’s Fund also reveals the extent of pressures on the NHS –
www.avensysmedical.co.uk/training WWW.CLINICALSERVICESJOURNAL.COM I 21
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