After the NHS faced an unprecedented demand over the winter months, we take a look at how services coped and explore how improvements can be made to protect the public.
Theresa May faced a backlash when, once again, hospitals struggled to cope under increased demand over the winter. Many routine operations were cancelled, with reports of people dying in hospital corridors. The crisis was so serious, 68 A&E doctors from across the country wrote to the Government with their concerns.
Figures released at the beginning of January stated that 95% of NHS hospital beds in England were full. The statistics showed that in just one week, 16,690 patients waited inside ambulances at A&E for over 30 minutes. In England during the same week, only 20% of ambulance services managed to meet their target of reaching critically ill people within seven minutes.
And just as the Aussie flu crisis struck, bed closures were made due to norovirus or diarrhoea and vomiting, leaving 944 beds unusable. Hospital admissions for flu was around 2.5 higher compared to the same time last year, according to figures for the week ending 31 December.
Meanwhile, the CQC took the decision to pause some routine inspections of NHS acute services, GP practices and urgent care services planned for January.
Sir David Behan, Chief Executive of CQC, said at the time: “As we highlighted in our State of Care report, the entire health and social care system is at full stretch – now an increase in respiratory illness and flu has further intensified this pressure.
Supporting the NHS system
“To support the system as much as possible, we are rescheduling some routine inspections of services. This is to allow frontline staff and leaders to focus on continuing to ensure that people receive safe, high-quality care during this period of increased demand.”
Sir David said that inspections scheduled in response to concerns about quality or safety would go ahead as planned, adding, “It is important to reiterate that these pressures do not originate with and are not restricted to Emergency Departments, or to NHS acute trusts. As we set out in the interim findings from our first six local system reviews, this is a whole-system issue, which demands a whole-system response.”
A joint report by the Health Foundation, the King’s Fund and the Nuffield Trust recommended that an extra £4billion should be injected into the NHS next year – the Government pledged just £1.6billion more, bringing the total budget to £126billion.
So how can the NHS avoid a meltdown next winter, as it faces a tight budget again? Sir David recommended that the long-term solution “must be for health and care providers and commissioners to collaborate to provide health and social care services that meet the needs of their local population, with a stronger focus on keeping people well and helping them stay out of hospital, and on reducing variation that can inhibit people’s access to and choice of services”.
Richard Murray, director of policy for The King’s Fund, said, “Despite the phenomenal efforts of NHS staff, the proportion of patients seen within four hours at major A&Es in December is the lowest for well over a decade. This reflects the intense pressure on the NHS and once again highlights that this winter is proving to be the most difficult for many years. Emergency admissions are at their highest ever level for a single month and 4.5 per cent up on December last year, underlining unprecedented demand for hospital services.
“The data, while not fully validated, suggests these pressures have continued into the new year. The decision to cancel planned operations will have a significant impact on patients and is a last resort, but the figures for bed occupancy show that hospitals are effectively full.
“Despite the welcome additional funding for the NHS in the last Budget, the service has reached the limit of what it can deliver within current funding levels. A new funding settlement is needed for the NHS and social care, building on the recommendations of the Barker Commission.”
Janet Morrison, chief executive of Independent Age, the older people’s charity, expressed concern about the elderly being released too early from hospital in order to free up beds, adding, “The increases in A&E attendance, emergency admissions and NHS 111 calls are a stark reminder of how important it is to make sure people are only discharged from hospital when they have the right support and care in place, so they don’t find themselves back in hospital days or weeks later. With so many people being discharged into a care home, it’s also essential that there are places in high-quality care homes available, so people don’t find themselves simply moved from a hospital bed, to a bed in a care home rated inadequate by CQC and then back into the over-stretched NHS.”
