A range of key capacity issues and concerns have converged today, leading to warnings that the winter pressures facing the NHS have reached a “watershed moment”.
Newly-published figures on NHS performance in England are some of the worst ever recorded and trusts themselves have warned that there are no longer sufficiently staff or beds to ensure safety.
“We need to be realistic about what we can provide on the funding available”
Meanwhile, a group of doctors have warned in a hard-hitting letter that patients are “dying in hospital corridors” and latest figures show a continuing rise in cases of influenza.
First thing this morning, NHS Providers revealed that it had warned the government that the pressures currently being experienced by frontline services this winter are a “watershed moment”.
The organisation, which represents 98% of trusts, said in a letter to health secretary Jeremy Hunt that there were “not enough beds and staff to ensure the standards of care and safety that patients rightly expect”.
In addition, it said an increase in flu cases, more respiratory illness and cold weather had “pushed the service up to and beyond its limits this winter”.
“This kind of pressure has an effect across the whole system”
NHS Providers said urgent decisions on long term funding for health and social care must now be taken. It has also called for a full review of how well the health service had ultimately handled this winter.
NHS Providers chief executive Chris Hopson said: “The NHS is at a watershed moment. Despite planning for winter more thoroughly and extensively than before, it hasn’t been sufficient. Rising numbers of flu cases and more respiratory illness have placed intolerable pressures on staff.
“The NHS is no longer able to deliver the constitutional standards to which it is committed,” he said. “We need to be realistic about what we can provide on the funding available.
He added: “If we continue to run the NHS at close to 100% capacity, day in day out, permanently in the red zone, it’s not surprising that the service can’t cope when we get a high, but entirely predictable, spike in demand.”
Laster in the morning, NHS England published a report on accident and emergency performance showing that 85.1% of patients were seen within four hours in all A&E departments in December.
“Without more staff and more funding, this crisis risks continuing to run into spring and summer”
This represents the “lowest performance figure” since the collection of this information began, noted NHS England, and is below the 95% standard, which was last achieved in July 2015.
Even poorer, just 77.3% of patients were seen within four hours in type 1 A&Es – also the worst type 1 performance since collection began.
Nigel Edwards, chief executive of the Nuffield Trust think-tank, also highlighted that just a week into the new year, and with two months of winter to go, bed occupancy levels were running at 95%.
“This is despite the effects of cancelling non-urgent operations and the small respite provided by lower bed occupancy over Christmas,” he noted.
He added: “Monthly figures show that A&E performance levels in December slumped to their lowest since records began and just three NHS trusts in England met the four-hour A&E target.
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“This kind of pressure has an effect across the whole system: in December almost 70,000 patients waited on a trolley to be admitted to hospital for four hours or more,” said Mr Edwards.
Dame Donna Kinnair, director of nursing, policy and practice at the Royal College of Nursing, said the latest performance figures “demonstrated” why it was being described as a watershed moment.
“Fewer trusts than ever before were able to meet the A&E four-hour target, almost 100% of hospital beds were full every day last week, way above the 85% safe limit recommended by experts, and almost 1,000 beds a day were lost to norovirus outbreaks,” she said.
“We can no longer call this a winter crisis – without more staff and more funding for the NHS, this crisis risks continuing to run well into spring and summer,” added Dame Donna.
Meanwhile, it was then revealed that doctors were publicly warning that patients were dying in hospital corridors because safety was being compromised by “intolerable” conditions.
The warning came in a letter to prime minister Theresa May, which was signed by 68 senior A&E doctors from across England and Wales.
In the letter, they claimed patients were having to sleep in make-shift wards set up in side-rooms and trolley waits of up to 12 hours were being routinely seen as staff struggled to find free beds.
Thousands were also being left in the back of ambulances waiting for A&E staff to take them in and over 120 patients a day were being managed in corridors in some places, some dying prematurely.
Unison head of health Sara Gorton said she hoped the two letters would “be the wake-up call the government needs to finally take action”.
“With services stretched to the limit, it is staff and patients who are being left to bear the brunt of inadequate funding,” she said. “NHS finances are in a dire state across the country, demand is going up but funding isn’t.”
Finally, at 2pm this afternoon, Public Health England published data showing that seasonal flu levels have continued to increase in the last week across the UK.
Over the last week, it said there has been a 78% increase in the GP consultation rate with flu like illness, a 50% increase in the flu hospitalisation rate, and a 65% increase in the flu intensive care admission rate.
The main strains circulating continue to be flu A(H3N2), A(H1N1) and Flu B, noted Public Health England in its weekly report.
- NHS England’s weekly winter situation reports, published on its website, provide regular updates on NHS bed occupancy, ambulance delays and other indications of pressure