‘Humanitarian crisis’ in the NHS?

The British Red Cross has said it has deployed staff to help in hospital and provided transport for discharged patients due to the current ‘humanitarian crisis’ in the NHS. 

The charity has said that it has supported the East Midlands Ambulance Service and is currently in talk with a number of hospitals about providing additional support.

In a statement, its chief executive warned that patients are being sent home without clothes in some cases, with inappropriate care when they get home leading to them suffering falls and not being found for days. 

The Red Cross called on the UK Government to ‘allocate immediate funding to stabilise the current system and set out plans towards creating a sustainable funding settlement for the future’.

It comes as the Royal College of Medicine has warned that only 77.62% of patients were seen within the four-hour target in the past week, the worst performance since it started measuring two years ago. This is despite an increase in beds being made available. 

Is this a situation you recognise? Is the term ‘humanitarian crisis’ over the top?

Comments (40) Add yours ↓
  1. Roger Kirby Professor of urology

    The Prime Minister rejected a warning from British Red Cross that hospitals are facing a “humanitarian crisis” after the organisation stepped in to support the overstretched health service. Ms May acknowledged the NHS was under pressure but told Sky News the Government was addressing the issue of an ageing population, adding that health funding was at record levels.

    “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need. They did that, we gave them that funding, in fact we gave them more funding than they required,” she said. “Funding is now at record levels for the NHS, more money has been going in.”

    But Mark Porter, council chair of the British Medical Association, said spiralling patient numbers and the lack of additional funding provided for health and social care meant the service was still struggling in real terms.

    January 10, 2017 Reply
  2. Matthew Bultitude Consultant Urologist

    Personally humanitarian crisis is over the top. Needs to be put into context with the “humanitarian crisis” that occurs in disasters such as the Sri Lankan tsunami and Haiti earthquake. However clearly the situation is not good and a real throwback back to the 80’s.

    Of course funding is at “record levels” as most things go up with inflation. However with a growing economy, increasing and ageing population, the percentage of GDP spent on NHS is going down as shown in this report by The Kings Fund: https://www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally – so in fact we still lag behind our European neighbours and the % spend of GDP is falling. Interesting in this report the say that if spending kept pace with economic growth, that by 2020/21, the NHS would have £16 billion more than currently planned.

    So while we are all familiar with politician spin, the hard facts do not match the rhetoric and I’m not sure that any front line staff will feel that the government “gave them that funding [that they asked for]” Nor that “In fact we gave them more funding than required”. So presumably the government is suggesting that the current crisis is due to profligate hospital trusts overspending and not a financial squeeze!

    January 10, 2017 Reply
  3. Roger Kirby Professor of Urology

    Theresa May must invest in the NHS immediately to stem a health service crisis that is putting lives at risk, Britain’s leading doctors have said.

    Vital NHS services are “struggling or failing to cope”, said senior medics at the Royal College of Physicians (RCP), which represents more than 30,000 doctors across 30 specialties.

    RCP Registrar Andrew Goddard Reported thar the organisation’s members had expressed fears “that the whole system was collapsing, that there is a crisis”.

    “Our hospitals are over-full, with too few qualified staff,” wrote RCP President Professor Jane Dacre in a letter to the Prime Minister signed by the prestigious body’s nearly 50 council members.

    “We are treating more patients than ever before. This increase in patient need – as our fellow citizens live longer, with more complex conditions – is outpacing the resources we have to care for them safely.”

    The RCP joins a growing multitude of voices warning of intense pressures facing the health service after the British Red Cross called the situation in NHS hospitals a “humanitarian crisis”.

    January 11, 2017 Reply
  4. Peter Rimington Skivvy

    Tidal waves in Sri Lanka and earthquakes in Haiti are certainly international humanitarian crises. But 40% of A&E depts going into risk, waiting times for acute care rocketing and patients dying without getting care in a hospital not to mention the lack of care outside of hospital, and this in one of the richest countries in the world, with the apparently best economy in Europe at years end, constitutes a first world humanitarian crisis. Just what planet do these politicians live on? Where’s Jeremy Hunt? Certainly not inspecting these hospitals to see for himself what’s going on!
    Down on the Sunshine Coast we have turned corridors behind A&E into wards and are apparently minus 15 beds. But we are still doing elective surgery! Truly, I despair of the level of incompetence in NHS management. And I fear that incompetence, inability to plan, lack of future proofing and sheer refusal to acknowledge facts has driven the NHS past the pint of no return! To quote Fraser from Dads Army, ” We’re doomed! We’re all doomed”!

    January 11, 2017 Reply
  5. Roger Kirby Professor of Urology

    Theresa May has admitted NHS patients are suffering “unacceptable practices” after being confronted with the story of a sick toddler treated on hospital chairs because no bed was free.

    However, the Prime Minister sparked anger in the Commons when she insisted there were only a “small number of incidents” – rejecting growing fears of a crisis. She also turned her fire on the Red Cross after it warned of a “humanitarian crisis” in the health service, condemning that language as “irresponsible and overblown”.

    Jeremy Corbyn used all six of his Prime Minister’s Questions to urge the Government to step in to tackle the growing problems in the NHS – accusing Ms May of being “in denial” and urging her to “listen to Siân”, who took her 22-month-old nephew into hospital.

    The Labour leader said of the case: “There was no bed, he was treated on two plastic chairs, pushed together with a blanket. And she says one of the nurses told her sister ‘It’s always like this nowadays’.”

    Mr Corbyn added: “Does the Prime Minister and the Health Secretary think this is an acceptable way of treating a 22-month-old child, needing help?”

    In reply, Ms May said: “I accept there have been a small number of incidents where unacceptable practices have taken place. We don’t want those things, but what matters is how you then deal with them.

    “That’s why it’s so important that the NHS does look into issues where there are unacceptable incidents that have taken place and then learns lessons from them.”

    January 12, 2017 Reply
  6. Peter Rimington Skivvy

    Surely it is all government who must look into these issues and learn lessons form them! The Royal College of Physicians has written to Ms May and told her the NHS is “understaffed, underfunded and under resourced”! There’s a lesson there all right!

    January 12, 2017 Reply
  7. Roger Kirby Professor of Urology

    More than four in 10 hospitals in England declared a major alert in the first week of this year, new figures have shown.

    As A&E departments are overwhelmed and the health service comes under increasing pressure, the data from NHS England shows the crisis is growing – and NHS bosses warn the flu peak has not yet hit.

    Overall, NHS hospitals issued 222 serious alerts in six days.

    The NHS England data, which covers the period up to January 8, shows the overall number of alerts was around six times higher in the six days up to last Sunday, compared to the previous six days (from December 28 to January 2).

    Six NHS trusts reported a “level 4” alert, meaning patient safety was at risk, at least once during the week.

    Those six trusts were:
    University Hospitals Bristol NHS Foundation Trust
    North Bristol NHS Trust
    Royal Liverpool and Broadgreen University Hospitals NHS Trust
    University Hospitals of Leicester NHS Trust
    University Hospitals of North Midlands NHS Trust
    Southport and Ormskirk Hospital NHS Trust

    January 13, 2017 Reply
  8. Roger Kirby Professor of Urology

    Health secretary Jeremy Hunt has said more GPs should be working in A&E departments and care homes to relieve the pressure on emergency services.

    Talking on Radio 4’s Today programme, the health secretary said that there was a need to recognise A&E was for accidents and emergencies, with GPs based in the departments seeing the 40% of A&E patients who don’t need emergency care.

    In addition to GPs in A&E, Mr Hunt said he now wants to ‘expand the number of GPs operating in care homes’.

    This follows an NHS England pilot of an ‘enhanced health in care homes’ enhanced service which requires GPs to do weekly ward rounds in care homes, which GP leaders said would stretch available GPs too thinly.

    January 13, 2017 Reply
  9. Roger Kirby Professor of Urology

    An increasing number of patients are having to endure long waits for operations, according to a study that provides the latest evidence of the NHS’s failure to meet waiting time targets because hospitals are so busy.

    Analysis by the Royal College of Surgeons found that over the past year an average of 193,406 people a month did not get surgery within 18 weeks of being referred.

    The figure compares with 139,240 the previous year and 105,427 four years ago, and is the NHS’s worst performance by this measure since 2008. It covers patients waiting for operations including for broken limbs, traumatic injuries, brain conditions and eye problems.

    Ian Eardley, the college’s vice-president, said: “We are now struggling to meet the standards and timeliness of care that the public rightly expect. Waiting longer creates prolonged pain, uncertainty and immobility for patients and is stressful for them and their families, especially those who may be very ill or in significant pain.

    “Many of these patients are older and in the most serious cases, such as heart or cancer surgery, waiting longer could have a big effect on the quality of someone’s life and their eventual recovery from surgery.”

    He said the sharp rise in the number of patients waiting longer than 18 weeks suggested the NHS had passed a tipping point.

    January 13, 2017 Reply
  10. Roger Kirby Professor of Urology

    All doctor’s surgeries in England will open from 8am to 8pm, seven days a week, Theresa May has vowed, unless they can prove there is no demand from patients.

    Ministers hope improving access to GPs will ease pressure on hospitals, which has become critical. There is increasing exasperation in Government that the lack of GP appointments is driving patients to seek treatment in hard-pressed hospital accident and emergency departments.

    Nearly half – 46 per cent – of GP surgeries were still closing at some point during “core” weekday working hours, according to a recent finding by the National Audit Office (NAO). This was in spite of three-quarters of them having received extra funding to provide extended cover.

    However, doctors’ groups have hit back at Ms May, accusing her of trying to “scapegoat” GPs. In addition, GPs will be warned that in future money to surgeries which are not open when patients want to visit will be cut.

    The director of acute care for NHS England Professor Keith Willett has recently estimated that 30 per cent of the patients attending A&E would be better cared for elsewhere in the system. Meanwhile the latest official figures showed more than four in 10 hospitals in England declared a major alert in the first week of the year as services came under increasing pressure.

    January 14, 2017 Reply
  11. Roger Kirby Professor of Urology

    Theresa May is urging GP surgeries to make more effort to provide a seven-day service as she seeks to deflect blame for the deepening crisis in the NHS.
    With pressure mounting on the prime minister, amid growing evidence that hospitals are struggling to cope with surging winter demand, Downing Street issued a statement on Friday saying that surgeries should do more to ensure they offer appointments in the evening and at weekends. GP leaders reacted angrily to the announcement and accused May of trying to scapegoat family doctors for the unfolding NHS crisis.
    A Downing Street source said: “Most GPs do a fantastic job and have their patients’ interests firmly at heart. However, it is increasingly clear that a large number of surgeries are not providing access that patients need – and that patients are suffering as a result, because they are then forced to go to A&E to seek care. It’s also bad for hospitals, who then face additional pressure on their services.”

    January 14, 2017 Reply
  12. Christian Brown Consultant urologist

    When will the top brass just admit the NHS is broken and it needs re-building. I dont believe its just about who is managing the hospital and running an efficient department. Everything is different these days, our population, our demographic, and most of all our health needs and expectations, but its the same NHS.

    I am on call this weekend and have completed a ward round of all patients at the request of the MD, 25% of our in patients were cleared medically over 2 weeks for discharge and await some type of placement with family expectations higher that what can be delivered so the patients are stuck. 25% are post operative majors so they cannot be discharged and 50% are legitimately in hospital and need our care.

    There is no more we can do but still the A&E seminar room has patients lined up on trolleys and a 4 hour would currently be seen to be very desirable. Next week I have been told no elective operations will take place at all including cancer.

    Split elective and emergencies, charge patients with minor complaints to attend A&E and their GP and adopt the 5p plastic bag concept – if you pay you will use it less (http://www.bbc.co.uk/news/science-environment-36917174), apparently we use 80% less plastic bags than we used to!

    January 14, 2017 Reply
  13. Roger Kirby Professor of Urology

    The head of the Health Select Committee has said Theresa May must apologise for trying to “scapegoat” GPs over overwhelming pressure faced by the NHS. Conservative MPs have turned on the Prime Minister after she said the lack of surgeries offering extended opening hours was causing patients and overstretched A&E departments to suffer.

    Former GP Sarah Wollaston said the Government was “failing to take responsibility for a system-wide issue which is not just about primary care”.

    “I do feel this is going to backfire, I think it was the wrong thing to say, and I think frankly they should apologise,” said Dr Wollaston, MP for Totnes who has been health committee chair since June 2014.

    Downing Street has said GP surgeries are not doing enough to meet NHS commitments to see patients twelve hours a day, seven days a week amid a growing crisis leaving hospitals unable to cope with demand. In a statement, Ms May’s office expressed its frustration at the failure of GPs to offer services every day from 8am to 8pm unless they can prove the demand from patients is not there.

    January 15, 2017 Reply
  14. Roger Kirby Professor of Urology

    WThe Prime Minister is “in denial” over the crisis facing the NHS and is scapegoating health professionals with a demand for GP surgeries to be open every day, Jeremy Corbyn has said. In his second major speech of 2017, the Labour leader also reiterated his calls to take failing private care homes and the railways into public ownership.

    He added that 380 care home businesses have been declared insolvent since 2010 and that the social care system is at “serious risk of breakdown” unless more money is invested. His speech – part of his relaunch and attempt to build on a populist momentum – came after Theresa May expressed frustration at the failure of more GP practices to offer extended opening hours, amid intensifying pressure on NHS hospital services.

    Downing Street warned surgeries in England that refuse to open 8am to 8pm seven days a week will lose funding unless they can prove there is no demand from patients. But Mr Corbyn criticised the warning, adding: “The Prime Minister tells us this morning that the real reason we have a crisis in the NHS is not because her Government has slashed billions from social care budgets and underfunded our health service.

    January 15, 2017 Reply
  15. Roger Kirby Professor of Urology

    It has been claimed that 7,000 NHS beds have been lost in England over the last six years, but the actual total is much larger. Official NHS data show that available general and acute medicine beds have reduced by 9,000, while those for mental health and learning disability have declined by 6,000, giving an overall loss of 15,000 beds. So far, so bad.

    But this is not the most alarming part of the story. One in 16 beds have been lost in general and acute medicine – but one in five beds in mental health. Given that mental health services had already, in the move to community-based care, lost the majority of their beds, this subsequent reduction seems particularly disproportionate.

    As a result, the remaining mental health beds have been continually over-occupied. The accepted level of bed occupancy for efficient use is 85 per cent – for mental health, this has continued to increase from 87 per cent in 2011 to over 90 per cent now. The pressure on these beds, already excessive, has reached a level that too often renders impossible any efficient management of these expensive resources.

    January 15, 2017 Reply
  16. Roger Kirby Professor of Urology

    The NHS and social care are seriously underfunded. That was the unequivocal message from the boss of NHS England, Simon Stevens, in evidence to the Public Accounts Committee on Wednesday.

    In a combative performance in which he took several thinly disguised swipes at the Prime Minister’s advisers who had briefed against him before his appearance, Stevens left no one in any doubt that more money is needed if the public’s expectations are to be met. His evidence brought to the boil debates that have been simmering for some time. Stevens challenged the government either to find more money for the NHS and social care, or be honest with the public about the consequences.

    January 15, 2017 Reply
  17. Roger Kirby Professor of Urology

    Senior doctors are concerned about the number of cancer patients having their operations cancelled amid “tremendous pressure” facing the NHS in England this winter.
    Ian Eardley, from the Royal College of Surgeons, said a shortage of beds was one of the causes.
    Such surgery is usually protected under treatment time guidelines, he added.
    The NHS said it was “pulling out all the stops” to ensure patients receive surgery “as quickly as possible”.
    A spokesman for NHS England said there had been a steady increase in the number of operations over the last 15 years and more people were surviving cancer than ever before.
    ‘Current pressures’
    Guidelines for hospitals in England stipulate that cancer patients should be seen within 31 days and receive primary treatment within 62.
    In November 2016, the latest period which NHS figures are available for, the 62-day target for treatment to start was missed – with 83.5% of patients being treated in that timeframe instead of 85%.
    Mr Eardley, vice president of the RCS, said most hospitals were able to see more than 90% of patients within that time period, but in the past year “it’s been more difficult to achieve that”.
    He said that while cancer operations were cancelled “from time to time”, especially during the winter, the RCS had heard from its members in England about an increasing number of cancellations within the last week.
    “There are current pressures – since Christmas particularly – and the number of cancelled operations has been going up,” he told the BBC.
    “The NHS is under tremendous pressure – more and more patients are going to A&E and there is more difficulty in getting patients home, and it’s not something we are comfortable with at all.
    “If we could get patients home more quickly and effectively, we could carry on with doing surgery more quickly and more effectively.”
    He added that solving the shortage of beds caused by problems with arranging care in the community would be “the easiest thing to do most quickly, although there are other longer-term problems and there also needs to be a broader review of the NHS.”

    January 15, 2017 Reply
  18. Roger Kirby Professor of Urology

    Hospitals across the UK are cancelling “urgent” cancer operations as the NHS winter crisis worsens. Some patients have reportedly been told with just a day’s notice that their surgery has been postponed, with a leading surgeon saying it was “extremely worrying” that hospitals had resorted to the decisions.

    Cancer operations have previously held a protected status but the demand for beds and lack of social care capacity has encroached on that. Clare Marx, president of the Royal College of Surgeons, told The Observer: “Feedback from our members suggests that since the start of January, a large number of hospitals across the UK are now cancelling cancer surgery. This will be extremely worrying to patients and their families.

    “It is heartbreaking for a surgeon to have to explain to a patient who has cancer that their operation has had to be cancelled as there are no beds available. It is increasingly clear that no part of the system and no patient is immune from the pressure the NHS is experiencing.”

    January 16, 2017 Reply
  19. Roger Kirby

    Patient demand is rising faster than the budget increases allocated to the NHS in England.
    Yet the number of hospital bed numbers has fallen steadily in recent years. So what is going on?
    The total number of overnight hospital beds in England fell from 144,455 at the start of the 2010/11 financial year to 129,458 in the middle of 2016 (the last recorded figures). The number of day beds over that period increased from 11,783 to 12,480.
    Looking further back into history reveals a sharper rate of decline.
    That current figure of overnight beds compares with almost 300,000 in 1987-88 according to figures from the Nuffield Trust.
    There was a steep fall in the late 1980s and early 1990s, then a more static position between 2000 and 2005 and then a resumption of the downward curve.
    The fall in bed numbers coincided with big changes in patterns of care.
    Institutionalised mental health treatment gave way to more care in a patient’s local community so fewer beds were needed.
    Elderly care medicine changed too, with more older patients cared for closer to home.
    Medical advances meant that more patients could be treated as day cases.
    Average stays in hospitals for those needing overnight beds have fallen. There was a similar trend in other healthcare systems.
    As bed numbers fell in England, occupancy rates did not shoot up. This suggests that the health service has been more efficient with its care and dealing with more cases outside hospitals.
    Over the first three months of 2016 in England, 89% of beds were occupied on average compared to 86.6% over the same period in 2011.
    But has the system reached a tipping point? Hospital bed occupancy rates have crept up to 95% in the first weeks of 2017.
    Trust chiefs have reported days when they have been literally full with a new patient admitted only when one has been discharged.
    Back in October 2014, a Nuffield Trust report noted that pressures were immense with demographic change and an ageing population the most significant drivers.
    “Our analysis shows that if admission rates continue to rise, the NHS will need an additional 6.2m ‘bed days’ by 2022 – which equates to 22 hospitals with 800 beds each,” it said.
    Nuffield went on to say that building new hospitals was not the answer and that curbing demand had to be part of the solution along with more joined up health and social care to keep people out of hospital where possible.

    January 21, 2017 Reply
  20. Roger Kirby Professor of urology

    Health leaders have roundly rejected the prime minister’s claim that the NHS is well funded, amid multiple signs that winter pressures have become widespread, straining the service severely.

    Theresa May told Parliament this week that she accepted there had been ‘a small number of incidents where unacceptable practices have taken place’ in the NHS but that extra funding for health and social care had been agreed.

    She has separately suggested the NHS received more than it requested in the Government’s spending settlement – a claim decried by leading think tanks, politicians and doctors.

    Ms May’s apparent rejection that the NHS has hit crisis point comes after official figures reveal that heightened demand since the beginning of last month had caused widespread problems in hospitals.

    Nuffield Trust analysis finds that, from 1 to 27 December, a third of English NHS trusts issued serious alerts about the pressures they were encountering.

    Fifty out of 152 issued OPEL (operational pressures escalation levels) declarations at level 3 – ‘major pressures compromising patient flow’ and level 4 – ‘unable to deliver comprehensive care… [with] increased potential for patient care and safety to be compromised’.

    A separate analysis, released by NHS England last week, reveals the time patients are stuck in beds because of discharge delays had risen again – by 26 per cent – from 153,200 in November 2015 to 193,700 in the same month last year. The proportion of delayed transfers owing to social care had also increased from 31.1 per cent to almost 35 per cent over the same period.

    NHS England chief executive Simon Stevens told the Commons public accounts committee that it would be ‘stretching it to say the NHS has got more than it asked for”.

    January 24, 2017 Reply
  21. Roger Kirby Professor of urology

    Royal College of Surgeons president Clare Marx said the picture was “very disappointing” as these operations and treatments could make a huge difference to people’s lives.
    “Someone waiting for a gall-stone removal will be in a lot of pain and discomfort.
    “The longer you wait for a hip or knee replacement the less likely you are to have good outcomes. These waits really matter.
    “The standards of care are being eroded and we don’t want it to get worse.”
    But Richard Murray, from the King’s Fund think tank, predicts the numbers on the waiting list will keep rising.
    He expects to see the total break through the four million barrier by the spring.

    February 5, 2017 Reply
  22. Roger Kirby Professor of Urology

    A month after the Red Cross let off a distress flare, warning of “humanitarian crisis” in our health service, the fight to save the NHS has turned into a battleground. Jeremy Hunt, the Health Secretary, remains in post despite an eye-wateringly long list of tactical transgressions that would have seen any other previous minister off months ago, but the crises within the service mount up without a solution.

    A&E departments are full, leaving ambulances lined up outside, some forced to close due to midwinter pressure; hospital bed space is at a premium as cuts to local government budgets play out in reduced availability of social care for older or infirm patients; doctors are quitting the business or moving abroad; and, now, the recipients of the service are losing their patience.

    As the NHS creaks under the triple pressures of rising demand for instant services, a growing population living longer with chronic health conditions, and falling investment in real terms, the appetite for supporting a free at the point of access service available to all is waning. A new survey has found that an almost equal percentage of Britons would be happy to pay upfront charges for some NHS care as would be willing to pay more income tax to sure the long-term future of the health service in its current form.

    February 7, 2017 Reply
  23. Roger Kirby Professor of Urology

    Parts of the NHS are providing “unacceptable” care to patients, Jeremy Hunt has admitted. The Health Secretary said there was “no excuse” for failings documented at some hospitals, in an interview with the BBC. Mr Hunt claimed that the Government was doing what it can with extra financial support for the NHS this year and suggested long-term reforms could help.

    However, the Government is cutting NHS spending per person in real terms over the coming years. MPs on the Health Committee have warned that the Government is exaggerating how much help it is giving the health service. There are numerous signs that the health of the NHS has deteriorated under Mr Hunt. The numbers waiting more than 18 weeks for routine operations in hospitals has risen more than 163 per cent in four years, while nine out of 10 hospitals have had unsafe numbers of patients in their wards this winter.

    Leaked documents appeared to show record numbers of patients waited more than four hours for A&E care last month while the Government has moved to quietly privatise the in-house NHS staffing agency despite an increasing reliance on expensive agency staff. Mr Hunt was accused of “hiding” in January after the British Red Cross declared a “humanitarian crisis” in the health service, calling for more funding.

    Yesterday morning, when confronted about the poor care that some patients have received, Mr Hunt said: “It is incredibly frustrating for me. I’m doing this job because I want NHS care to be the safest and best in the world and that kind of care is completely unacceptable, no one would want it for their own family.” He continued: “I think what you have to recognise is there are positive things as well as negative things and there is huge commitment in the NHS to sort out those negative things and the particular pressure point we have is A&E

    February 11, 2017 Reply
  24. Roger Kirby Professor of Urology

    An unprecedented increase in “excess deaths” in England and Wales could be linked to underfunding in the NHS and social care system, new research suggests. “Relentless cuts” to the health service might be behind 30,000 deaths in 2015, argued researchers in two articles published in the Journal of the Royal Society of Medicine. The Government has angrily refuted the claims, calling the reports a “triumph of personal bias”.

    Researchers from the London School of Hygiene and Tropical Medicine, the University of Oxford, and Blackburn with Darwen borough council said 2015 saw the greatest rise in mortality for almost 50 years in England and Wales – with a particularly large spike seen in January. They examined other possible explanations for the deaths, including data inaccuracies or whether there had been a major epidemic. But they concluded that “the evidence points to a major failure of the health system, possibly exacerbated by failings in social care”.

    Professor Martin McKee, from the London School of Hygiene and Tropical Medicine, said “the impact of cuts resulting from the imposition of austerity on the NHS has been profound”. He said: “Expenditure has failed to keep pace with demand and the situation has been exacerbated by dramatic reductions in the welfare budget of £16.7bn and in social care spending. The possibility that the cuts to health and social care are implicated in almost 30,000 excess deaths is one that needs further exploration. Given the relentless nature of the cuts, and potential link to rising mortality, we ask why is the search for a cause not being pursued with more urgency?”

    February 19, 2017 Reply
  25. Roger Kirby Professor of Urology

    This week, London has seen the first signs of spring, with lighter mornings and evenings, along with several bright days. However, in terms of health policy and the NHS, minds are still firmly focused on how the NHS has dealt with winter. On Tuesday, NHS Providers released a report examining how the NHS coped in the peak winter months of December 2016 – February 2017. It was not comfortable reading for senior NHS managers and the Health Secretary, Jeremy Hunt, as it revealed that hospitals had to provide 4,500 extra beds a day to cope with the demands on the service over the period.

    The media highlighted that the number of beds was equivalent to opening eight extra hospitals. This, alongside the fact these beds were often placed in areas not usually used for patients, has rightly caused concern about patient safety. Chris Hopson, Chief Executive of NHS Providers, commented on the release of the report: ‘These figures show a system running hot, and – in particular times and places – overwhelmed by the demands placed on it, risking patient safety. The situation is unsustainable, and we must plan now to ensure we don’t put staff and patients under such intolerable pressure next year.’

    The Labour Party was quick to comment on these figures, with Shadow Health Secretary John Ashworth linking the pressures on A&E Departments over winter to funding. Further political pressure was piled on when the Royal College of Emergency Medicine released the results of a cross-party poll of nearly 100 MPs, which found only 33 per cent believed A&E Departments have enough money and staff to provide safe care.

    It was, therefore, timely that Jeremy Hunt was set to deliver a keynote speech at the Reform Health policy conference days later, with a particular focus on patient safety. During his speech, he told hospitals that they must meet the four hour waiting time targets for A&E, which has been missed since July 2015. He said that the extra £2bn for social care provided by the Chancellor in the Budget would help to ease pressures on A&E, by tackling the problems around delayed discharge of patients from hospitals to community care settings.

    While winter pressures have always been a difficult subject for Health Secretaries and the NHS, in his tenure as Health Secretary, Hunt has always positioned patient safety as a priority. Time will tell whether the Chancellor’s extra funding for social care will make an impact on the additional pressures caused by winter. However, what is clear is that winter pressures and A&E Departments are topics that Hunt and Simon Stevens will have to review and consider carefully ahead of next winter to ensure patient safety in NHS hospitals is upheld and at the centre of any decisions.

    March 11, 2017 Reply
  26. Roger Kirby Professor of Urology

    The rising tide of obesity, the over-reliance on hospitals and the adult social care funding shortfall are among the many factors that have left the National Health Service in a state of “crisis”, according to a new House of Lords report.

    The report by the Long-term Sustainability of the NHS Committee calls the NHS the country’s “national religion” and “an iconic part of Britain’s social fabric”, but argues it is not sustainable in its current form.

    It calls for a new campaign to highlight the obesity “epidemic” and urges ministers to look into the possibility of an insurance scheme to enable people to prepare for their care needs in older age. It says the health service should remain free at the point of use, which would require “a shift in government priorities or increases in taxation”.

    The report, written by a House of Lords Select Committee that looked specifically at the question of the long-term sustainability of the NHS, criticises the “short-sightedness” of successive governments to plan ahead. It argues for the creation of an office for health and care sustainability to look 15 to 20 years ahead to “counter the endemic NHS disease of short-termism”.

    It says preventable health problems, particularly obesity, were putting a “significant burden” on the system. The report also drew attention the funding crisis in adult social care, which it described as “on the brink of collapse.”

    “The funding crisis in adult social care is worsening to the point of imminent breakdown,” the report says. “Pressures in social care are the greatest external threat to the long-term sustainability of the NHS.”

    April 5, 2017 Reply
  27. Roger Kirby Professor of Urology

    Two in every five GPs are planning to quit the NHS, a new survey suggests, amid warnings that “perilously” low morale among family doctors is fuelling an “enormous crisis” in frontline healthcare.

    Jeremy Hunt has said GP surgeries should be open seven days a week, from 8am to 8pm, and has announced plans to place doctor generalists in A&E departments to help ease overwhelming pressures faced by NHS hospitals. But the British Medical Association (BMA) said GPs across the country were already “struggling to cope with rising patient demand, stagnating budgets and widespread staff shortages” – and warned this could get worse if Brexit results in an exodus of doctors from overseas.

    Academics at Exeter Medical School surveyed more than 2,000 GPs, with over half reporting low morale. The researchers said the Government “needs to take robust action more swiftly and urgently than previously thought” to avert a crisis if their results were echoed in other regions.

    The number of GPs working full-time has fallen, according to figures published last month, despite Government proposals to recruit 5,000 more by 2020. There are now 34,500 GPs in the NHS, a decrease of 0.3 per cent from last year. A BMA survey of 3,500 GPs in England found around a third of practices had vacancies for doctors they had been unable to fill for at least a year. There has also been a 15 per cent rise in the total number of GP consultations in the last five years, according to The King’s Fund – three times the overall growth rate of the GP workforce in that period.

    April 12, 2017 Reply
  28. Roger Kirby Professor of Urology

    The next government must drastically increase NHS spending or face a public health “ticking time bomb”.

    A report from the the British Medical Association (BMA) claims the health service is at “breaking point” due to a combination of unhealthy lifestyles and deep cuts to health budgets. The doctors’ union said swingeing cuts of £400m by 2020-21 and failure to curb persistently high levels of obesity, smoking and binge drinking will plunge the NHS further into the red, while condemning patients to suffer from preventable diseases.

    “In England, successive governments have failed to deliver a long-term plan to improve public health, and too often evidence-based public health measures have been kicked into the long grass,” said Dr Mark Porter, council chair of the BMA.

    Dr Porter said the UK was “going backwards” on matters of public health: “Whoever is in government next, must make tackling the crisis in public health a priority. With the NHS at breaking point, and demand on services only set to rise, we are facing a ticking time bomb.”

    May 11, 2017 Reply
  29. Roger Kirby Professor of Urology

    One in nine nursing posts in England is unfilled, figures have revealed, indicating that the number of vacancies has doubled over the past few years. Two thirds of NHS hospital trusts in England planned for a greater proportion of nursing support staff last year than a year earlier, according to new data obtained by the Royal College of Nursing (RCN) from NHS trusts in England. These startling figures, obtained through Freedom of Information rules, have prompted professionals to warn there is a “lethal cocktail” of rising demand and falling pay in the sector.

    According to the RCN, they suggest care providers have increasingly hired fewer registered nursing staff, with the number of vacant nursing posts having doubled since 2013. The College has subsequently warned the Government that safe staffing levels must be enshrined in law in order to ensure that nursing directors don’t have to fight for funding.

    Janet Davies, general secretary of the RCN, said the Government could be accused of offering “nursing on the cheap” in place of recruiting and retaining registered and experienced nurses. She will tell the RCN’s annual conference today in Liverpool: “A lethal cocktail of factors in the NHS has resulted in too few registered nurses and patient care is suffering. “Pressure and demand has spiralled upwards at the very moment nurses’ pay headed the other way. They stay behind after 12-hour shifts to give patients extra care and go home exhausted and sometimes in tears. Too many now feel no alternative but to leave nursing.”

    May 14, 2017 Reply
  30. Roger Kirby

    Nurses are to stage a summer of protests across the UK after a poll showed strong support for strikes over pay. The Royal College of Nursing (RCN) warned that unless the next Government drops the 1 per cent cap on pay it will hold a ballot on industrial action later this year, threatening the first ever strikes by its members. The RCN said nurses voted in a consultative ballot with nine out of 10 supporting action short of a strike, while almost four out of five backed strikes. More than 50,000 of the RCN’s 270,000 members took part in the poll. Another ballot would have to be held before any action takes place.

    The RCN has warned that low levels of pay are partly responsible for tens of thousands of unfilled nursing posts. Nurses have suffered a 14 per cent pay cut in real terms since 2010 because of a government cap on public sector pay, said the RCN. The formal pay cap of 1 per cent was introduced in 2015.

    May 15, 2017 Reply
  31. Roger Kirby Professor of Urology

    Theresa May has been warned to tackle the pressures facing general practitioners in England as one top doctor warns the service is on the “brink of collapse”.

    Urging leading politicians to “end their callous disregard for the health needs of citizens”, Dr Chaand Nagpaul, chairman of the British Medical Association’s GP committee, will say the Government is “turning a blind eye to the spiralling pressures” affecting the entire health and social-care systems.

    In today’s speech in Edinburgh at the national conference of Local Medical Communities – representing grassroots GPs – Dr Nagpaul will highlight the mounting workloads and staff shortages, adding practices have become “frighteningly vulnerable”.

    He will add that the health service has been “paralysed” by the vote to leave the European Union.

    “Far from the pledged investment of an extra £350m per week, audaciously plastered on double-decker buses, the reality is we’ve been cheated with the opposite: a deep freeze in NHS spend, continued savage austerity cuts and with politicians turning a blind eye to spiralling pressures affecting the entire health and social care system,” Mr Nagpaul will say.

    Data available from NHS England in April showed that 92 practices closed in 2016 – a record number – forcing patients to find a new surgery.

    May 18, 2017 Reply
  32. Roger Kirby Professor of Urology

    Could Britain’s love of the NHS have brought Theresa May’s hopes of a majority crashing down? The worst winter on record at A&E followed by repeated warnings over staff shortages, urgent funding shortfalls and patient safety after Brexit appear to have propelled the health service to the top of the public’s list of most important issues facing Britain today.

    A hung parliament leaves huge uncertainty over who will be in power in the coming years, and the future of the NHS is no more predictable. But voters have sent a clear message to Theresa May and Jeremy Hunt about their treatment of public services and the staff who keep them up and running. An exclusive poll for The Independent the day before the election found nine out of 10 people shunned the Prime Minister’s idea of a “Brexit election” and insisted on the importance of social and health services.

    June 9, 2017 Reply
  33. Roger Kirby Professor of Urology

    Patients may have to wait longer for NHS treatment as budgets are increasingly squeezed, the organisation that represents local health bodies across the country has warned.

    A predicted real-terms funding drop of £330m in the next three years will result in a “slowing down” of access to routine care, said Julie Wood, the head of NHS Clinical Commissioners.

    On paper, local health budgets appear to be increasing, with Theresa May claiming earlier this year that “funding is now at record levels for the NHS”. However, rising inflation and a growing population mean that by 2019-20, clinical commissioning groups (CCGs) – responsible for planning healthcare provision in each area of the UK – will face a shortfall of £5.72 per person on average compared to this year.

    “The potential consequences will vary from area to area but could mean taking decisions about slowing down access to routine care and thus slowing down spend,” said Ms Wood in a statement. “It could be about looking at where services are provided and it could be about looking at the relative priority of where the NHS spends its [money].”

    June 14, 2017 Reply
  34. Roger Kirby Professor of Urology

    A lack of hospital beds means the NHS is facing a “winter of woe”, senior doctors have warned, as new figures showed the health service is struggling with increasing demand.

    The NHS is losing more than 180,000 days of available beds a month, where patients are fit to leave hospital but face delays in being transferred, according to data released by NHS Digital.

    The warning that hospitals were poorly prepared for winter, from the Royal College of Surgeons (RCS), came on the same day that it emerged NHS England received 571 written complaints every day last year – the highest number on record.

    September 15, 2017 Reply
  35. Roger Kirby Professor Roger Kirby

    The number of patients who have been kept waiting in A&E for more than 12 hours in England has soared by 10,546 per cent in five years, figures show. Quarterly performance figures from NHS England show that in January to March of this year, 1,597 patients waited for over 12 hours to be admitted, compared with just 15 patients in 2012.

    The rise has been branded “catastrophic” by opposition politicians, who have urged the Government to take action and address the “chronic” under-funding of the NHS in the Autumn Budget. Doctors have issued several warnings over the past year of worsening conditions in overstretched hospitals, saying they are at breaking point due to overwhelming demand and bed shortages.

    The latest figures also show an increase in 12-hour waits in the spring months – a time when pressures traditionally start to ease. From April to June 2012, just two patients were kept waiting for more than 12 hours, while in the same period in 2017, the figure was 311 – an increase of 15,450 per cent.

    September 24, 2017 Reply
  36. Roger Kirby Professor of Urology

    Patients could be banned from going to accident and emergency departments unless they have been sent there by a GP or the NHS 111 helpline, a senior health official has suggested.

    Helen Thomas, national medical director for integrated emergency care at NHS England, said she had discussed piloting the idea with some hospitals.

    However, NHS bosses insisted that there were no official plans for such a scheme, which would be unlikely to work. Instead a campaign to urge people without life-threatening injuries to phone the NHS 111 helpline before going to A&E is being planned. Many could be treated by out-of-hours GPs or pharmacists.

    October 14, 2017 Reply
  37. Roger Kirby Professor of Urology

    Once again, the NHS is making headlines for all the wrong reasons. You’ll have seen that non-urgent operations and clinics are being postponed to cope with what is being described as “the winter crisis”.

    What is indisputable is that capacity in hospitals is at breaking point; many are operating at close to 100 per cent bed occupancy, which means that patients are being discharged sooner than they should be in order to create beds for the acutely ill who need admission, acutely ill patients are having to wait in corridors and ambulances waiting for beds to become available and medical and nursing staff are working under increasing pressure to stop the spinning plates from crashing to the floor.

    The media has suggested that the some of the causes of this crisis are as follows: winter viruses, inefficiency, drunks, GP appointments being unavailable, immigrants and lazy staff to name a few. However the fact that there has been chronic underfunding over the last seven years seems not to have been addressed too widely as a cause for the current problems.

    January 4, 2018 Reply
  38. Roger Kirby Professor of Urology

    WFunding to “transform” the NHS has only succeeded in propping up struggling services, and may have worsened health service finances in the long run, a report by the National Audit Office (NAO) has found.

    The public spending watchdog has criticised the Government for relying on short-term cash injections, which have been immediately swallowed up by soaring demand and pre-existing deficits.

    An extra £1.8bn in sustainability and transformation funding in 2016-17 was intended to give “breathing space” to implement reforms across the whole health system, including GP and mental health services. But NHS bosses warned it had merely “kept the show on the road” for another year, with the bulk of the money being used to prop up struggling hospital trusts and emergency services.

    January 19, 2018 Reply
  39. Roger Kirby Professor of urology

    Applications to study nursing in England have fallen by a third since the Government removed bursaries two years ago, meaning prospective nurses and midwives now pay £9,000 a year in fees. Ucas figures for the first wave of applicants hoping to start university courses in September 2018 show that the number of students wanting to study NHS nursing have again fallen sharply, by 13 per cent on last year.

    This is despite the Government dropping its bursary so that more nurses could be trained, as places were previously capped by what the NHS could afford. Nursing bosses said this ambition has failed and some form of incentive, such as student loan write-offs for nurses who are trained and work in the NHS, is urgently needed to avert “unimaginable problems” in the future.

    February 3, 2018 Reply
  40. Roger Kirby Professor of Urology

    Patients are facing delays to life-saving treatment amid warnings over a “staggering increase” in cancellations of urgent surgery. Nearly 1,000 urgent operations have been cut so far this winter for patients with life-threatening illnesses due to pressures on hospital resources, such as beds or staff, according to new analysis of NHS figures. The total represents a 40 per cent increase in cancellations since 2013-14, when 707 operations were cut, and a surge of 31 per cent since 2010-11 when there were 755 cancellations.

    Campaigners warned that patients could be put at risk by delays to vital care, while Labour accused the Government of presiding over an “unparalleled winter of discontent”. It comes after Health Secretary Jeremy Hunt was forced to apologise to patients when hospitals took the drastic step of postponing tens of thousands of routine procedures last month.

    February 25, 2018 Reply

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