Ambulance moving at night.
Experts from two think tanks say “policy choices” and “underinvestment” are behind a crisis currently engulfing England’s public health system.
On Thursday, the National Health Service published its worst ever urgent and emergency care performance figures. The data shows long waits for ambulances and high bed occupancy, along with a staggering backlog of non-urgent procedures.
For months, hospitals have been struggling with high bed occupancy, partly linked to a lack of adult social care to support patients after discharge. This limits the number of beds available in hospitals and, in turn, slows down the admission of patients to emergency rooms.
This can cause overcrowding and make it difficult for ambulances to deliver patients to hospitals. As a result, fewer ambulances may be available to respond to calls as vehicles and their equipment get stuck in queues.
Experts say the Covid-19 pandemic has exacerbated underlying problems with the health service. Sarah Scobie, deputy director of research at the Nuffield Trust think tank, said in a statement: “The NHS should be on a journey to recovery, but today’s figures expose the reality: it is ‘a crisis in the resilience of health services, years in the making and the result of bad political choices and underinvestment’.
December, he added, saw a “scary mix” of shocks for the NHS, with covid-19, a poor flu season and very cold weather fueling demand for emergency services.
Tim Gardner, senior policy fellow at The Health Foundation, echoed Scobie’s comments, saying in a statement: “Today’s data shows that the NHS is facing an emergency, but the roots of this are found in policy decisions made over the past decade, not in cold weather or seasonal flu.”
He said there are “no quick fixes” for a service that has faced “a decade of underinvestment … a failure to address chronic staff shortages, onslaught on capital budgets and long-standing abandonment of adult social care.”
Continued pressure and long-term labor shortages have created intense working conditions for staff across the health service, many of whom are involved in ongoing strike action over pay. Ambulance and nursing staff have walked out on several dates in recent weeks, and junior doctors are currently voting on whether to strike.
Industry figures have called on the government to negotiate with union leaders to try to end the disputes.
Saffron Cordery, who leads hospital management body NHS Providers, said in a statement: “Trusts are now busier than ever, with A&E attendances and delayed discharges reaching record highs.
“With pressure on the NHS from almost every direction, trust leaders are facing exceptional seasonal challenges amid an ongoing strike that shows no sign of resolution.”
He said the government “needs to talk to union bosses about pay to prevent further strikes”, and called on leaders to publish a fully funded workforce plan to tackle the “huge staff shortage” in what the NHS is facing.
But new NHS data showed some improvement, with the backlog of non-urgent procedures rising from 7.21 million to 7.19 million. Those numbers are still high, but it’s the first time they’ve fallen since May 2020.
Dr Layla McCay, director of policy at the NHS Confederation, said in a statement: “The figures show that healthcare leaders and their staff have put in a lot of effort and it’s great to see it paying off in reducing waiting list numbers for the first time since the pandemic.”
But, he added, “there is no hiding the fact that the NHS is in the midst of a very tumultuous winter”.
