Niall Dickson, Chief Executive of the NHS Confederation
“This report reinforces how difficult it is to transform services when budgets are so tight. There is simply not enough money to meet existing demand, never mind build up the new community services needed to create a sustainable system.
“The system is under enormous pressure and it is becoming increasingly evident that in some places care is not as good or as quick as it once was.
“Staff are continuing to ‘just about cope’ but the stress they are now under will eventually have an impact on patients.
“New money for STPs announced in the budget is welcome, but no one should underestimate the size of the challenge – the NHS and local government need to find new ways of working together, which embrace prevention and help keep people healthy.”
NHS Partners Network Chief Executive, David Hare
“NHS hospitals are currently working flat out to cope with the pressures in A&E. However, as the Kings Fund report rightly highlights, it is important that the millions of people requiring vital elective treatment such as hip operations are not forgotten. We therefore echo the report’s concerns that the rise in block contracts for elective procedures is having an adverse impact on patient care as demand is rising, and call for a greater focus on ensuring patients are allowed to choose their care provider with the funding following their decision.
“The report is also right in saying that far too little attention is currently paid to community health services which are vital if the NHS is to move to a more preventative model. The independent sector, which plays a significant role in providing NHS community services, should be used more extensively to invest in new and remodelled NHS community services which help keep patients out of hospital and are also there for them after they have been discharged.”
Professor Neena Modi, President of the Royal College of Paediatrics and Child Health
“It’s heartening, and consistent with our own findings from the National Neonatal Audit, that the quality of neonatal services in the UK is considered high. But there is no room for complacency.
“Variation between services particularly in the extent to which agreed standards are being met is a concern, and appears to be largely driven by variable local funding decisions. Equally worrying are the workforce challenges with medical and nursing staff shortages, and the number of neonatal units operating above recommended occupancy levels. This poses serious threats to patient safety from overstretched staff, and the all too frequent need to transfer sick babies between hospitals because of a lack of capacity. Financial pressures also appear to be limiting access to allied health professionals who make important contributions to the care of sick babies and their families.
“We constantly hear the claim that the NHS is unaffordable. So it is extraordinary that major areas of waste such as the internal market that is estimated to cost between £4.5 billion and £10 billion to administer, have not been abolished, and that a growing proportion of public funds are being diverted to for-profit providers. Poll after poll also shows that the public would be willing to pay a bit more to support the NHS through general taxation. So the claim of unaffordability would appear to be a myth.
“This report is a timely reminder of the human cost of the financial squeeze being imposed upon the NHS. Government owes it to this, and future generations, to eliminate variability in the quality of services, invest in the workforce, and provide a long term financial plan to ensure the sustainability of UK health services.”
Dr Mark Porter, BMA council chair
“As this report shows, patients are unfairly suffering the consequences of a deliberately underfunded NHS at breaking point. The public health budget in England has been continually raided, with a significant impact on preventative services, slowing any long-term improvement in population health and failing to save money.
“Pressure on all services is rising and care is increasingly being rationed. Waiting lists should not be rising, and yet they are. Decisions on patient care should be based on individual clinical need and following royal college or other evidence-based standards. Doctors always want to deliver the best possible care for our patients, but we can’t continuously plug gaps by penny pinching and poaching from elsewhere in an overstretched NHS.
“This report highlights that working conditions in the NHS have got worse in recent years, with burnout and stress-related illness increasingly common. The root causes of these issues, such as high workload and stretching staff too thinly, urgently need to be addressed to deliver the motivated, positive workforce we would all want to care for us.
“The government shows no sign of easing the funding pressures. It must fill the £30bn funding shortfall and produce a long-term strategy that addresses the fundamental workload and funding challenges that are currently overwhelming many health services.”