NHS ‘must solve unfinished business’ to improve patient care

19 Jun 19

The ambition of improved patient care set out in the NHS long-term plan will be jeopardised without a commitment to invest in the health workforce, capital infrastructure and social care, a charity has warned.

Analysis from the Health Foundation, together with a survey of health leaders carried out by the NHS Confederation, found that overstretched services and badly maintained facilities would see the health service continue to struggle in the face of rising demand.

The budget of NHS England is to increase by over £20bn in real terms between 2018-19 and 2023-24 under the new funding settlement.

However, if NHS earnings are to keep pace with that of other sectors, the extra money will allow hospital activity to increase by 2.3% over the period – well short of the 2.7% needed to meet demand, the analysis said. 

The survey of health leaders found that only one in four believed their local health system would be able to reduce growth in demand, while nine in 10 were not confident that the NHS would be able to deliver the reforms set out in the plan without a long-term financial settlement for social care.  

On staffing, two-thirds doubted that health systems would be able to meet the increased demand for staff required under the plan, with the shortage of mental health staff, GPs and community nurses the most pressing concern.

The Health Foundation also warned that the decision to withhold the bulk of the new investment until 2023-24, with only modest increases planned for the next two years, ran counter to the front-loaded settlement announced last summer. This would make it hard to support a period of initial investment in care outside hospitals.

Dr Jennifer Dixon, chief executive at the Health Foundation, said there was “urgent unfinished business” if the NHS was to deliver its vision to improve patient care. 

“There are mounting workforce shortages, the social care system is starved of funding, capital investment is going backwards, and public health funds cut,” she said.

“This all piles demand on the NHS and risks swallowing up the extra money and leaving far less to modernise care, reduce waiting times and prevent illness in the first place.”

She called on government to set out long-term funding for public health, capital investment, workforce training and social care and to ensure they received adequate resources to support the ambitions of the long-term plan.  

Chief executive of the NHS Confederation Niall Dickson said that while NHS leaders were optimistic about the future, they also had serious concerns. 

“They face crippling staff vacancies, rising demand for care, lack of investment in buildings and equipment, and the drastic cuts to social care and public health that are fuelling extra demand on A&E and other frontline NHS services,” he said.

“Failure to address this in the next spending review will put the ambitions of the NHS plan in jeopardy, and patients will not feel the full benefits of the extra £20bn of funding.”

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