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NHS Providers warns of toxic health service culture and worsening patient experience

New report paints bleak picture of emergency department waiting times, standards of care and other major workforce issues

New report paints bleak picture of emergency department (ED) waiting times, standards of care and other major workforce issues

  • Only one in 20 NHS trusts in England believe they can meet four-hour ED target in 2019

  • Performance expected and savings demanded are 'beyond reach'

  • Government says it is committed to a fully-funded, long-term plan for the NHS

Waiting times
55% of NHS trusts in England said they would not be able to hold the size of the waiting
list of people in need of planned care. Picture: iStock

The number of people waiting more than four hours for emergency department (ED) care at hospitals in England will reach 3.6 million next year, health leaders have warned.

NHS Providers also predicted the number of people waiting more than the target of 18 weeks for routine care will reach 560,000 by March 2019 – a rise of nearly 80,000 compared to current levels.

Patient experience of care is likely to 'continue to fall below the standards trusts consider acceptable next year', according to NHS Providers' new report into the prospects for the health service in 2018-2019.

It also warns that trusts are struggling with major workforce issues and need government help.

Long-term NHS funding plan

The bleak report states that just one in 20 NHS trusts believe they can meet the four-hour ED target next year – which demands that 95% of patients should be admitted to hospital, transferred to another provider or discharged within four hours.

Meanwhile, more than half (55%) said they would not be able to hold the size of the waiting list of people in need of planned care, according to a survey of 97 NHS trust chief executives and finance directors.

NHS Providers said that while it welcomed prime minister Theresa May's indication that the health service would get a long-term funding plan, it said this would not resolve immediate challenges.

Its new report warns that levels of performance expected and the savings demanded from the NHS for next year are 'beyond reach'.

Eroding public confidence

The organisation, which represents NHS acute, ambulance, community and mental health services, warned that setting unachievable tasks for NHS trusts creates a 'toxic' culture in the health service by weakening accountability, damaging morale and eroding public confidence in the NHS.

Its latest report sets out how most EDs have been told to get back to the 95% four-hour ED target by March 2019, but the authors wrote: 'There is nothing to suggest that this scale or width of improvement is deliverable without a major system change.'

The authors added: 'If the NHS fails to improve performance and it holds at current levels, we estimate over 3.6 million patients will not be treated within four hours in 2018-2019.'

Not just about funding

NHS Providers chief executive Chris Hopson said: 'Our analysis shows the levels of performance expected and the savings demanded for next year are beyond reach.

'The new financial year begins next week. While we strongly welcome the prime minister's commitment to increase long-term funding for the NHS, it makes no immediate difference to the tough task facing trusts for next year.

'This report also shows – as the prime minister argued – that this is not just about funding.

'Trusts are struggling with major workforce shortages and they need help from the government here too.'

Department of Health and Social Care response

In a written statement to the Commons on Wednesday, health and social care secretary Jeremy Hunt recognised pressures in the health service over the winter period but added that more than 55,000 people were seen within four hours per day in February – 1,000 more people per day than in the same month last year.

A Department of Health and Social Care spokesperson said: 'We know that demand continues to grow, and that staff have never worked harder, which is why we are funding a pay rise to more than one million dedicated staff as well as expanding the number of training places for doctors, nurses and midwives.

'The prime minister and health and social care secretary have committed to a fully-funded, long-term plan for the NHS, which will be agreed with NHS leaders, clinicians and health experts, including NHS Providers, and the government gave the NHS top priority in the autumn budget, with an extra £2.8 billion investment.'

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