The NHS’s already precarious finances are facing a “nasty hangover” after hospitals cancelled tens of thousands of operations recently in a bid to avert a full-blown winter crisis, experts have said.
Handing large numbers of operations over to private providers and hiring extra staff to cope with extra demand during December and January has also dealt a big blow to NHS trusts’ efforts to balance their books, the King’s Fund said.
The backlog of patients needing non-urgent surgery as a result of the widespread postponement of procedures this winter will also force patients to wait even longer for their operation, Richard Murray, its director of policy, said.
“Increasing spending on agency staff, outsourcing work to the private sector and suspending planned treatment may have helped to relieve pressure in the short term but are likely to result in a nasty hangover as hospital finances take a hit and waiting times increase further,” said Murray.
The service’s finances are deteriorating so sharply there is a real risk the Department of Health could bust its budget for 2016-17, according to the thinktank’s new analysis of NHS performance.
Its latest quarterly monitoring report on how the NHS in England is faring predicts that it is facing several more years of finding it impossible to live within its budget, despite government orders to do so. Hospital trusts ran up a deficit of £2.45bn last year and are on course to overspend by over £1bn again this year.
For example, 53% of hospital trusts and 63% of NHS clinical commissioning groups (CCGs) that the King’s Fund surveyed are fairly or very pessimistic about ending 2017-18 in financial balance. And looking further ahead, 74% of trusts and 86% of CCGs doubt they will achieve the huge savings expected of them by 2020 under NHS England chief executive Simon Stevens’s Five Year Forward View (pdf).
The NHS is now overspending by so much that many hospital trusts plan to cut staff in order to try to put their finances back in order. “Financial pressures mean some trusts are reducing their workforce, with 29% of finance directors reporting that their organisations have plans to reduce permanent clinical headcount,” the King’s Fund’s analysis said.
However, it said doing so risked endangering patients’ quality of care, especially with demand for medical treatment rising so sharply because of the ageing and growing population. Almost two-thirds (63%) of hospital trusts and 56% of CCGs think patient care has worsened in their area over the last year, the study found.
“It will be very challenging to reduce the clinical workforce at a time when many NHS hospitals are routinely running at high bed-occupancy levels and demand continues to rise,” the report said.
The research also appears to refute Theresa May’s view that patients’ difficulty in accessing GP services is a key cause of A&E units becoming so busy. In January she was criticised by GPs when she made clear that surgeries should open for longer to help relieve the strain on hospitals.
Asked to identify the key reasons for hospital overload, 80% of trust personnel surveyed cited the severity of patients’ illnesses, 70% mentioned the inability to discharge patients who were fit to leave, 61% said rising demand, and just 20% highlighted access to general practice.
Dr Helen Stokes-Lampard, the chair of the Royal College of GPs, said: “We’re pleased this report shows, without any doubt, that the recent winter pressures that have been facing our colleagues in emergency departments have not been because GPs – or any other clinicians in the NHS – aren’t working hard enough, but that the resources and workforce to cope with escalating patient demand simply aren’t there.”
Overall, said Murray, the fund’s findings “are further evidence of a service buckling under the strain of trying to meet rising demand while maintaining current standards and should give the chancellor pause for thought ahead of next week’s budget”. While Philip Hammond is expected to use his first budget on 8 March to boost funding for social care, he is unlikely to increase spending on the NHS.
The Department of Health declined to comment. NHS England said: “NHS frontline services have come under real pressure this winter but it is a tribute to the professionalism and dedication of GPs, nurses and other staff in A&E who continued to see, treat, admit or discharge the vast majority of patients within four hours.”
NHS finances facing "nasty hangover" after bid to avert winter crisis
Hiç yorum yok:
Yorum Gönder