Trying to meet performance targets on inadequate funding levels is placing an “unfair and unsustainable burden” on NHS staff, warn trust managers.
In a report titled “mission impossible”, the organisation NHS Providers has warned that current and expected pressures on the health service are unrealistic without more resources.
“It is unprecedented for us to warn the NHS will not be able to deliver on its commitments”
NHS Providers, which represents trusts and is part of the NHS Confederation, said what was currently being asked of services in the coming financial year was “well beyond reach”.
Its report – titled Mission Impossible? The NHS provider ask in 2017-18 – stated that greater “realism, flexibility and support” were needed be trusts around what they could deliver in the next financial year.
The report highlights the demands that are being placed on NHS trusts compared against next year’s significantly lower funding increases, revealing a “currently unbridgeable gap”.
For example, it said trusts must absorb a projected 3.1% increase in overall demand from patients and 2.1% increase in costs including pay, buildings and laboratories.
They must also meet key performance targets, such as for accident and emergency and routine operations, while delivering new commitments on cancer and mental health.
“Trying to meet performance targets on inadequate funding levels is placing an increasingly unsustainable burden on NHS staff”
NHS Providers report
However, they must do this while collectively balancing their books and with “sharply reduced” NHS England funding, with increases dropping from 3.6% this year to 1.3% in 2017-18.
NHS Providers called on NHS leaders to set more realistic performance trajectories against the key targets, and for more support for trusts.
It also suggested reviewing whether more money could be redirected to frontline care from commissioning, the Department of Health and its arm’s length bodies.
The report said the patient impact of continuing on the current trajectory would be 1.8 million A&E patients falling outside the target to deal with 95% in four hours – half a million more than this year.
In addition, on average, 100,000 more patients than expected would wait longer than 18 weeks for routine surgery, compared to this year’s figure of 40,000, it predicted.
Meanwhile, trying to meet performance targets on inadequate funding levels was also “placing an increasingly unsustainable burden” on NHS staff, said the report.
It noted that the 2016 NHS staff survey showed only 30% of staff agreed that “there are enough staff at this organisation for me to do my job properly”, with 47% disagreeing.
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In particular, the report warned of the increasing patient safety risk over the winter period, with an increasing burden on NHS staff trying to “deliver impossible targets without adequate funding”.
NHS Providers was it was “particularly concerned” by the impact on patient safety of current bed occupancy levels in both acute and mental health settings.
“In a number of local systems, we are now putting patient safety at unacceptable levels of risk,” it stated.
NHS Providers chief executive Chris Hopson, said: “The NHS is a can-do organisation which achieves extraordinary results for patients every day.
“NHS trusts are treating more patients than ever before and performance remains good by international standards,” he said. “So when those trusts say that they can’t deliver what’s currently being asked for next year, it is time to sit up and listen.
“It is unprecedented for us to warn the NHS will not be able to deliver on its commitments before the financial year has even started,” said Mr Hopson.
He added: “We have now reached the point where, on the resources available, NHS trusts can no longer deliver what the NHS constitution requires.”