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Winter crisis is now year-long crisis, suggests new NHS Confederation report

Regulators should use discretion when considering whether to withhold extra funding from health and care organisations, the NHS Confederation says in a new report.

The report, System under Strain, shows how increasing year-on-year demand, coupled with flat funding, is not just a winter phenomenon affecting accident and emergency departments.

The report highlights how demand and funding pressures are placing strain on all parts of the health and care system throughout the year. The membership body is calling on NHS England and NHS Improvement to capitalise on the opportunities presented by their recently revealed plans for greater collaboration.

Both bodies can do this by working more closely with local provider and commissioner organisations on system-wide solutions to address demand pressures, the report suggests.

Linking access to extra funding directly to organisational performance can stand in the way of necessary collaborative action and in effect penalises patients in areas where need is greatest, the report warns.

Niall Dickson, chief executive of the NHS Confederation, said: “This shows the winter crisis has become the year-long crisis. It shows this is not about one part of a system but a set of interdependent services that cannot operate effectively without relying on each other.

“Without new ways of delivering services and sustained investment, NHS and care services will not simply not be able to cope. We are not currently doing enough for the old, the sick and the vulnerable, and as things stand it will get worse.

“The recent report we commissioned from the Institute for Fiscal Studies and Health Foundation ended the fantasy that we can simply go on with the current system and current funding. “And it is not just about money. Local providers and commissioners are coming together to find ways to manage growing demand. But they need much more co-ordinated support from the centre. Recent moves suggest this may be about to happen, but we urgently need better ways to support and incentivise new ways of working which deliver the right care at the right time."

  • The goal that 95 per cent of patients should wait no longer than four hours in accident and emergency departments has not been met since July 2015
  • More than a quarter of patients (27 per cent) wait 11 weeks or longer to access NHS eating disorder services
  • 500,000 ambulance hours were lost in 2015-16 due to delayed transfers of care at hospitals
  • The number of 999 calls received increased by 21 per cent between 2013-14 and 2016-17
Original article link: http://www.nhsconfed.org/media-centre/2018/06/system-under-strain

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