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NHS faces difficult winter as demand for care increases, report says

Big rises in demand for healthcare mean the NHS is heading into winter with its finances under pressure and performance against several key indicators at their worst level for more than a decade.

That’s the conclusion of the latest Quarterly Monitoring Report (QMR) from The King’s Fund, which covers the period July to September.

It shows that the NHS is now treating more patients than ever before.

Increasing demand for services is reflected in the number of GP referrals, which increased by about 3% over the last year, while emergency admissions via A&E are 4% higher than the same quarter last year.

This is putting increasing pressure on NHS services, which are struggling to maintain standards of care as a result. The QMR shows:

  • 9.4% of those attending A&E waited more than four hours, which is the worst performance for this time of year for more than a decade
  • 9.4% of patients waited longer than 18 weeks to begin hospital treatment, the worst performance since targets were revised in 2012
  • July to September saw a record high of 568,774 bed days lost as a result of delays in discharging patients from hospital; this is 29% higher than in the same quarter last year.

The rise in the number of delayed discharges underlines the impact on the NHS of cuts to social care budgets and other problems in co-ordinating care.

The critical state of social care has led a number of health organisations to call for the Chancellor to make more money available for social care in next week’s Autumn Statement.

2016/17 is meant to be the year the NHS stabilises its finances but this is also proving a challenge with nearly a third of NHS trusts forecasting that they will miss their ‘control totals’ (new financial targets set for each NHS organisation). This is up from 13% in the last quarter.

While most CCGs continue to forecast surpluses and have also set aside 1% of their budget in a ‘risk reserve’ to help manage NHS deficits, 20% of CCGs say they are relying on this money being released to meet their own financial targets and over 70% are concerned about meeting efficiency targets.

This creates the risk that the position may worsen later in the year, the report says.

Furthermore, analysis of data from more than 200 practices shows an almost 10% increase in patient contacts (including telephone consultations) over the past two years, confirming the huge pressures on general practice.

Chris Ham, Chief Executive of The King’s Fund, said: “The NHS is treating more patients than ever before, and these findings show that rising demand is putting its services under increasing pressure.

“The NHS needs to redouble efforts to manage demand and this will require investment in out-of-hospital services via the sustainability and transformation plans now being developed across England.

“The most pressing priority for next week’s Autumn Statement is to provide more funding for social care, following years of budget cuts. Not only would this benefit some of the most vulnerable people in society, but it would also help relieve pressure on the NHS.”

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