Speaking ahead of his appearance at the Health Select Committee yesterday (Tuesday), the head of the NHS Confederation has said a blame game about which parts of the service are at fault do not help. There is no single cause or straightforward solution for the situation we face, but what is clear is that the pressures are growing and we need to take urgent action across the board if we are to improve services for patients and get the service on a sustainable footing.
Mike Farrar, chief executive of the NHS Confederation, says:
"Like many hard working frontline staff in the NHS, we have been ringing the alarm bells about urgent care services struggling to meet the demands of patients. The recent headlines do not lie - the pressures are growing and we are getting closer and closer to the cliff edge.
"In the last ten years, emergency admissions through A&E have increased by 51%; that's an extra 1.25million more patients going in to hospital on an unplanned basis.
"If we continue with this trend we will see another extra half a million patients cramming into our A&E department in the next three years. This will be simply impossible for our hospital services to cope with, despite the heroic efforts of staff to date."
Mr Farrar continues:
"There is no use in pointing the finger at patients, or any one part of the system when in reality it is a perfect storm of different mounting pressures causing our problems - GPs, hospitals, NHS 111, the ambulance service and social care.
"These pressures have been compounded by three years of major structural reforms, a lack of honesty about the situation we face, and the service not being able to respond quickly enough to the financial pressures it faces.
"The problems that longer waiting times in A&E highlight are an inability of the service to manage the flow of patients across and between our organisations. In particular, it reveals the imbalance of investment in primary, community and social care compared to hospital care.
"This runs contrary to the strategy that Governments, NHS leaders, the public and patients all feel to be essential for a sustainable NHS. People may march on the streets to protect local hospital services but the vast majority would rather stay healthy and remain living independently with the support of primary and social care for as long as possible This depends on getting the balance as well as the level of investment in services right. If we don't, many people will experience the prospect of waiting longer again for the care they need."
On the proposed solutions, Mr Farrar says:
"We need to take urgent action and bring all parts of the service together to make sure patients have access to the right services, in the right place at the right time. NHS leaders need to be able to spend money differently, moving it away from crisis admissions. We need NHS and social care services working together better so that people are not in hospital when they could be getting the care they need at home.
"And we need a revolution in our approach to healthcare, using technology to help us change our lives in the way that banking and retail sectors have done. Providing advice and services online and more information to help us help ourselves will help support people to stay healthy and out of hospital when they don't need to be there.
"The Government has made a number of helpful announcements over the past week about reforming the way we pay for care, integrating health and social care and focusing on the care of older people. These initiatives may be three years too late, but they may help the train coming off the tracks.
"Alongside these solutions, we need courageous political leadership. We need politicians of all parties to have an honest conversation with the public about the pressures we face, the money we have and how we spend it in the future.
"If we can get this right, then we may have a fighting chance of preventing disaster."