Doctors’ leaders are today warning that the NHS in England is unlikely to recover from the pressure it faces during the winter, with trends suggesting that the health system is entering a state of year-round crisis.
New analysis published today [Friday] by the British Medical Association (BMA) shows that last winter was one the worst winters on record, with all key performance markers showing a health system that is struggling to cope with demand.
Bed occupancy, delayed transfers of care and waits at A&E are all increasing, with patients waiting longer for ambulances, treatment and admission. Targets are consistently not being met across the health system. Today doctors’ leaders are warning that these trends are only going to worsen.
This was not a particularly challenging winter in terms of external factors – it was a noticeably mild December; in central England the average temperature in January was just 0.2C below the recent historic average. Similarly, there were no widespread outbreaks of influenza or norovirus.
New BMA analysis of NHS performance in England shows that:
- Over the first three months of 2017,bed occupancy on general and acute wards was 91.4% - the highest figure recorded;
- Mental health bed occupancy at the end of the year was 89.7% - also the highest figure recorded;
- There were 328 fewer available mental health beds between January and March than between October and December;
- Between November 2016 and March 2017, almost a fifth of patients waited over four hours to be seen at major A&Es;
- The number of trolley waits in that period also dramatically increased – in 2016/17, over 290,000 patients waited at least four hours to be admitted – an increase of almost 70,000 on the previous year;
- Despite the NHS England target that no patient wait more than 12 hours on a trolley, the number of such incidents has dramatically increased over the past seven years, from 38 in the winter of 2010/11 to 2608 last winter - an increase of 6763 per cent.
- Between the start of December 2016 and the middle of March 2017, 94 of 152 trusts issued major alerts on at least one day to say they couldn’t cope. Two-thirds of the most serious alerts were issued by just ten trusts;
- From November 2016 to March 2017 there were, on average, 6708 patients experiencing a delayed transfer of care on any one day.
The startling new analysis has been published in the run-up to the general election where the BMA is calling on politicians to address the pressures across the healthcare system that prevent the delivery of high-quality, safe care by:
- Investing in the medical workforce to attract and keep the doctors we need;
- Prioritising high-quality training and education for doctors at every stage of a medical career;
- Agreeing a long-term solution to the funding, capacity and staffing challenges overwhelming the health and social care systems;
- Ending repeated breaches of safe levels of bed occupancy and work with local government to reduce the impact of pressures in social care on hospitals;
- Ensuring Sustainability and Transformation Plans (STPs) in England are realistic, evidence-based and properly funded, with patient care, not savings, as the priority.
Commenting on the findings, Dr Mark Porter, BMA council chair, said:
“These figures show that hospitals have just endured one of the worst winters on record, with patients facing unacceptably long waits for treatment. These delays are having a profound impact on patients' experience of the NHS and mean frontline staff are left working under extremely difficult conditions.
“This new analysis is particularly stark because it wasn’t a bad winter in terms of external factors. The weather was mild and there were no widespread outbreaks of flu or norovirus. The pressure the NHS is under is purely down to bad political choices, with years of chronic underfunding and investment in services failing to keep up with patient demand.
“Politicians are consistently missing their own targets across the health system and the NHS is clearly at breaking point. Pressures previously only seen during the winter months are now becoming the norm year-round, as current trends suggest that performance will continue to deteriorate rather than improve. This is compounded by staff and bed shortages and the threat of further cuts to services under so-called ‘transformation plans’.
“Our health and social care systems can no longer cope without urgent action. In the run-up to the general election, we call on politicians of all parties not to duck this crisis any longer. This means, as a minimum, immediately bringing investment in line with other leading European countries and outlining credible, long-term plans that will safeguard the future of the fully funded and supported NHS that staff want and patients deserve.”
Notes to editors
The British Medical Association (BMA) is the voice of doctors and medical students in the UK. It is an apolitical professional organisation and independent trade union, representing doctors and medical students from all branches of medicine across the UK and supporting them to deliver the highest standards of care.
- The new BMA analysis paper can be downloaded here.
- For press enquiries please email [email protected] or call 02073836448.
- More information on the BMA’s manifesto ‘A vote for health’ is available here and the BMA’s briefing paper on NHS pressures can be read here.