The mild days of late autumn are barely gone, yet concerns about a looming winter crisis in the NHS are already hitting the headlines. With financial pressure growing, performance targets slipping and hospitals already overstretched, a political storm has hit Westminster and Whitehall. Could another cold snap tip the NHS over the edge?
A SLIPPERY SLOPE?
Winter pressures in the NHS happen every year, as a result of higher emergency admissions and increased numbers of people requiring hospital care (e.g. people with respiratory conditions or winter viruses). Most of those affected are older people, many of whom have higher care needs and can be more vulnerable to the cold.
Yet, despite anticipatory planning and the usual precautions, there are growing concerns that accident and emergency (A&E) services are heading inevitably towards a midwinter meltdown. NHS statistics have revealed that A&E performance in late autumn this year has been worse than in the depths of last winter.
On average over the past four weeks, just 93.5% of patients attending A&E in England were seen within four hours, with 23 trusts failing to reach 90% last week. By contrast, above 95% of patients were seen within the required timeframe last winter.
WHAT ABOUT PATIENT SAFETY?
The unprecedented demand on A&Es has serious implications for older people’s health and experience of care. The high levels of bed occupancy have led to people being held in ambulances outside the hospital or waiting on trolleys for many hours. This has also had a knock-on effect on other hospital services, with patients having their appointments and operations cancelled.
For the many older people who are lonely and isolated, or living with frailty or dementia, the inability of A&Es to respond to their needs can be disastrous. Due to a lack of appropriate support in the community, they are often forced to wait until they reach a crisis for a response and rely on emergency admissions for help. Arriving in a worse state of health, they are then faced with a fraught and overstretched urgent care centre or A&E. Continue reading
December 3, 2014 in Autumn Statement, Government, Health, Health and Wellbeing, Home and Care, Public Policy
Tagged Age UK, Age UK blog, Ageing, ageing population, ageing society, crisis in NHS funding, Health, Health & wellbeing, NHS, NHS funding, older people, Tavistock Square debates
On the 23 October 2014, NHS England published its Five Year Forward View, a vision document for the future of the NHS.
The timing, and the timeline, is very deliberate: this is NHS England’s chief executive, Simon Stevens, setting his stall for next year’s general election.
Whichever party (or parties) form/s the next government will have to decide whether they take this vision on. And whether they are willing to pay for it.
This is a crucial point because Stevens has addressed the enduring taboo of money. Politicians are largely in a state of denial about the funding crisis facing the NHS, forecasted to be short by about £30 billion by 2020/21.
That’s just under a third of the annual budget of the NHS. Stevens is clear: if you want the NHS to continue providing a universal health care service, free at the point of delivery, you cannot escape the fact that more money will need to be found.
For a pre-election period, where more spending, even on the NHS, is avoided like the plague by political parties, this is the very definition of throwing down the gauntlet.
So what does the vision say? Continue reading