NHS facing serious challenges to maintain standards of care – report

The NHS faces 'serious challenges in maintaining standards of care', with senior managers worried about having the right levels of staff, according to a new report

The NHS Providers study of 158 chairs and chief executives from 125 NHS trusts also found concerns about NHS finances and the current state of mental health.

Some 57% of managers questioned were worried about their ability to maintain the right numbers of staff, both clinical and non-clinical, to deliver high-quality care.

More than half (53%) of those surveyed were confident they were currently able to provide high-quality care, down from 60% in November, while 8% said the care offered by their trust was very high quality.

But more than one third (37%) thought the care given to patients was average, while 2% said it was low quality.

Record demand 

The report said: 'NHS trusts are experiencing record levels of demand for their services.

'At the same time, patients have higher and more complex needs.

'Many trusts are now running at capacity levels beyond the recommended norm and levels in other advanced western health systems.'

Targets missed

The report said for the first time, the NHS is missing all four of its key targets: 75% ambulance response within eight minutes, 95% A&E four-hour waiting times, 92% 18-week elective surgery and 85% seen within 62 days of GP referral.

The study also looked at mental health, with a stark warning that the government's commitment to tackle injustices faced by people with mental health issues is being undermined.

It said the impact of increasing demand, too few staff and the failure of funding to get through to the frontline means core mental health services are being overwhelmed.

The poll included 43 chairmen and chief executives from 37 mental health trusts, of which more than 70% expected demand to increase this year.

Fewer than one in three felt confident they had enough staff to deliver existing services let alone extending or creating new services.

The report said that, in particular, trusts are struggling to recruit enough mental health nurses and psychiatrists.

Budget cuts

And 80% said cash intended for mental health from a national level is still not getting though the front-line and is partly being swallowed up in Clinical Commissioning Group (CCG) budgets.

Saffron Cordery, director of policy and strategy at NHS Providers, said: 'Having the right staff with the right skills in the right place is the only way to improve mental health services on the ground.

'But mental health trust leaders are struggling to find sufficient staff to deliver their current services, let alone find new staff to extend, transform or innovate services.

'And too often, trust leaders report that any extra funding is just used to fill existing gaps or to manage current demand, not improve service quality or access.

'Unless action is taken to address these areas of concern then the government's ambitions for transforming mental health care will not be met.'

Tackling stigma

Responding to the report, Sean Duggan, chief executive of the Mental Health Network, which is part of the NHS Confederation, said: 'There has been huge progress in the way mental health is talked about and recognised with campaigns such as Heads Together having a positive impact on tackling stigma.

'However with greater awareness of mental health comes extra pressure on services that are already stretched. The government has pledged to put mental health on a par with physical health but this needs to be reflected in investment and the continued progress of the Five Year Forward View for Mental Health. Securing a sustainable mental health workforce fit for the 21st century is a crucial part of this.

'Getting mental health services right will relieve pressure on other parts of the health system and we would urge the government to deliver on its promises and ensure mental health gets the equal status it deserves.'

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