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Letter to the PM: ‘Reinvigorate social care services and investment in infrastructure’

The Royal College of Physicians has written to the Prime Minister setting out their concerns on the future of the NHS.

The letter was signed by RCP president Professor Jane Dacre and 49 members of Council.

Here is the letter:

Dear Prime Minister,

As we start 2017, the NHS, its patients and staff are facing great difficulty. The quality of patient care is threatened by demands which the health service does not have the capacity or resource to meet.

Your 2015 manifesto stated that ‘patients, doctors and nurses are the experts on how to improve people’s health’. As the members of the Royal College of Physicians’ Council, representing 33,000 doctors across 30 specialties and 750 physician associates: we agree. This is why we are compelled to speak up.

We are fully committed to the NHS, which has seen extraordinary clinical advancements over recent decades, but we need urgent investment to continue to provide the quality of care people deserve.

The RCP, our fellows and members, want to work with you and your government to build on the NHS’s achievements, work towards the vision set out in the Five Year Forward View, and drive innovative new ways of caring for our patients.

We are on the NHS front line, working alongside professionals from every clinical discipline, managers and with colleagues in primary, community and social care. We see first-hand the patients who are coming in through emergency departments, and care for them in their hour of need.

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.

Our NHS is underfunded, underdoctored and overstretched. The ambulances queuing outside emergency departments are a visual testament to the crisis in social care and the NHS. Our hospitals are over-full, with too few qualified staff, and our primary, community, social care and public health services are struggling or failing to cope.

Patients are waiting longer on lists, on trolleys, in emergency departments and in their homes for the care they need. Pressures in social care are pushing more people into our hospitals and trapping them there for longer. An increasing number of people, although clinically ready to go home, cannot safely leave hospital as the care system is unable to cope.

People’s lives are being put at risk or on hold, affecting families across the country.

This is demotivating and demoralising the clinical workforce, and we have increasing reports of staff contemplating the sad decision to leave the NHS. Our members report working in clinical teams stretched too thinly to be as effective as they should be. In our recent survey of doctors in training, seven out of ten reported working on a rota with permanent gaps, and over nine out of ten reported gaps in nursing rotas.

It is essential that we match the demand on health services with the resources to meet it. We understand that the current financial pressures mean difficult choices. We welcome the decision to increase the number of medical students, and the commitment to extra resources for the health service.

But, front-line staff and managers across health and social care are clear: investment levels are not sufficient to meet current or future patient needs. As a result, in spite of rapid advances in clinical care, services are often too paralysed by spiralling demand to transform and modernise.

Promises of future investment will not address the very real challenges we face going into 2017: the time to invest is now.

The NHS is the embodiment of your view that ‘We have a responsibility to one another’. Without urgent investment, the NHS will fail to live up to this responsibility this winter. The immediate actions which would help the most are the reinvigoration of social care services and urgent capital investment in infrastructure. With investment, we can reverse the reductions in social care services available and start to address the increasing demands on the health service.

In 2017, let us – as the collective voice of physicians – work with you to create the thriving, sustainable health service that our country and fellow citizens deserve.

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