NHS frontline services are already under as much pressure as they usually face in the winter due to staff shortages and the inability of hospitals to discharge patients, the health chief said on Wednesday.
Speaking to senior health executives, NHS England chief executive Amanda Pritchard acknowledged that bed cuts had gone too far. But she blamed the difficulties in social care for hospitals, which remain unable to accept the growing number of seriously ill people in urgent need of care, and patients remain trapped in the back of ambulances outside A&E wards.
However, Health Secretary Sajid Javid warned that there would be no “quick cure” for the increasingly acute problems facing the NHS’s emergency services. And he made it clear that the service will have to deal with its many challenges without any new increase in money.
“Honestly, the situation we are currently seeing in the emergency departments and ambulance services is as challenging as every winter before the pandemic,” Pritchard told delegates at the NHS ConfedExpo conference in Liverpool.
While the growing need for care is a major cause of pressure on the NHS, “demand is not the whole story.” But she cited the inadequacy of social care as the main reason hospitals have so many patients who can’t be discharged even though they are medically fit to leave, and therefore why so many patients have to wait so long to get a bed.
“You can trace the line from delayed discharges, to the accumulation of A&E, all the way to a slower response time for the ambulance,” Pritchard said.
For many years, the National Health Service had fewer hospital beds than comparable countries, which in some ways shows how effective it is, she added. But hospital struggles show that “we have passed the point where this efficiency is actually ineffective.”
The service has already set up 53 “virtual wards” – where patients are treated at home to vacate hospital beds – but these initiatives alone are not enough, she added.
Last month, Mark Doherty, medical director of the West Midlands ambulance, said patients were “dying every day” because so many ambulances were tied up outside hospitals. Serious patient safety incidents caused by delays have quadrupled in the last year, he added.
In a harsh message to delegates, Javid told them to make better use of the record funding received by the NHS, not to expect any increase and instead modernize their way of working.
“The answer to all the challenges we face in healthcare cannot always be more money. I think it’s important to improve productivity.
“I do not want my children, no one’s children, to grow up in a country where more than half of public spending is on health care at the expense of everything from education to housing.
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Calling for the NHS to undertake a major reform, he said: “It is possible that you love the NHS and still demand change. The service should “reduce demand through prevention, early diagnosis and more effective care” and “improved use of capital, skills, management, data and innovative care models”.
Ahead of the conference, Matthew Taylor, chief executive of the NHS Confederation, blamed the service’s growing inability to meet the waiting time for underfunded care in the 12 years since the Conservatives came to power in 2010, and accused Javid of “Manager rape”.
“When you’ve been in government for 12 years, recognizing the scale of the problems that exist now, problems that clearly reflect the decisions made over those 12 years, are hard to make politically,” said Taylor, a former head of Tony’s 10 Politics. Blair.
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