Health leaders set priorities for new Government to tackle huge pressures

Health leaders across England have urged the incoming Government to address the critical issues that will improve and transform services for patients as they warn that a lack of staffing and failure to address the pensions crisis is putting care at risk.

In a survey carried out by the NHS Confederation ahead of the General Election and published today (Tuesday 19 November), workforce, reforming social care, and addressing capital investment feature as the most critical priorities for action.

Over three quarters of health leaders (76%) surveyed said that supporting and growing the NHS workforce should be a critical priority, ranking it highest at a time that there are more than 100,000 vacancies among clinical and nursing staff.

Nine in ten (90%) of the health leaders claimed that understaffing was putting patient safety and care at risk.

Also, more than four in five (83%) of health leaders who took part in the survey believe that the NHS Pension Scheme is having a detrimental impact on workforce pressures, with nearly seven in ten (69%) saying it is damaging patient care.

This comes as the latest performance statistics for the NHS last week show that demand for services has continued to rise, with the NHS treating more people than ever before. However, key targets for hospital care and A&E have hit their worst levels since the standards were introduced in 2004.

Nearly three in five (58%) health leaders surveyed by the NHS Confederation believe this winter will be the worst on record for waiting times and performance across the NHS.

While the existing targets have led to vital reductions in how long patients wait for treatment, nearly two thirds (65%) of the leaders surveyed now feel that the measures are not ‘fit for purpose’. More than seven in ten (71%) welcome the expected move towards more ‘nuanced’ access standards for the NHS in England. However, the Confederation’s independent sector providers do not support any moves to change the current standards.

The standards, including the four-hour target in A&E, have been used to measure the NHS’s performance since 2004 and are currently being reviewed.

Niall Dickson, the chief executive of the NHS Confederation, said:

“The NHS is heading into this winter with significant staffing and performance challenges. It is therefore little wonder that health leaders are deeply concerned about its ability to cope with demand, despite frontline staff treating more patients than ever.

“The views from our members should send a clear message to whoever forms the new Government on the scale of the challenge facing the NHS and how to make the service fit for the future. Workforce gaps, the growing social care crisis and historic underinvestment are the biggest threats to improving care for patients and transforming services, and each of these issues needs attention, as do the pension rules which are discouraging some doctors from taking on extra work and encouraging others to take early retirement.

“Alongside these issues, health leaders are clear about the need to reassess how we measure NHS performance with realistic targets that support staff to focus on the right patients at the right time.

“Targets have been a force for good and should not be abandoned, but we need to move away from the current cliff-edge approach where several minutes either side of a target represent success or failure. Any changes must underline the need for rapid access to treatment but in a way that ensures patients with the most urgent needs are given priority.

“There is no quick fix for all the challenges facing the NHS in England but there is a direction of travel laid out already in the Long Term Plan, and it is at least encouraging that no political leaders are proposing further reorganisation.”

The NHS Confederation carried out the survey across its membership – which includes NHS trusts, clinical commissioning groups and local integrated care systems – to gauge their priorities for the next Government. 131 senior leaders, including chief executives, chairs and directors responded to the survey.

Elsewhere in the survey, the NHS Confederation found:

  • Nearly all (98%) of leaders share the view that the worsening social care crisis is having a damaging knock-on impact on the NHS and patient care. Every single respondent felt that like the NHS, the social care sector needs its own long-term plan and significant investment.
  • More than nine in ten (93%) leaders agree that the capital investment that has been announced for the NHS is just the start of what is needed, particularly as key areas in mental health and community services have not been prioritised. When asked to select one priority area for long-term capital investment, IT infrastructure was the most popular choice (45%), followed closely by buildings (36%).
  • 84% of respondents said that improving care for people with mental health issues is a critical and high priority for their specific setting. This is a particular challenge given that vacancies are disproportionately high for services that support people with mental health problems and learning disabilities.
  • Two thirds of leaders (65%) agreed that the NHS does not need top-down reorganisation, of the likes of those introduced as a result of the Health and Social Care Act 2012. This suggests they support the direction of travel set out in the NHS Long Term Plan published in January.

The body has published a report, “Fit for the future: how should the incoming Government help the NHS?” and has written to the health spokespeople of the leading political parties to outline its key findings.

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