Only one in four NHS trust leaders are confident they have the right staff numbers, quality and skill mix to deliver high quality healthcare for patients and service users.
This is the key conclusion of a survey of trust CEOs and chairs, by NHS Providers, which suggests many leaders have greater concerns over staffing than funding.
The survey shows that only 22% are confident about having the right staffing levels in six months’ time.
172 chairs and chief executives from 136 hospital, mental health, community and ambulance trusts responded to the survey – well over half of all England’s 238 NHS trusts.
On the positive side, the report demonstrates that, despite rising challenges, trusts deliver when they have an achievable task and are given appropriate support and funding.
Trusts are successfully treating a record number of patients: 5% more emergency hospitals admissions, 8% more A&E attendances and 4% more ambulance calls in September 2016 compared to September 2015 for all NHS trusts and foundation trusts.
They are also on track to reduce last year’s record £2.45 billion deficit to £669 million, cut agency spending by a quarter and realise £3.2 billion cost improvement gains this year – this is £346 million (12%) more than last year.
However, the survey also reveals a range of growing concerns over how services for patients and service users can be sustained at current levels.
In the face of much higher demand than predicted and, despite their best efforts, trusts are missing nearly all of their key performance targets. Fewer than one in three (30%) trust chairs and chief executives expect performance against these targets to improve over the next six months.
Trust leaders share the CQC’s concern that whilst there is much good care being delivered, there is clear evidence of service quality starting to deteriorate. Only 10% of trust chairs and chief executives are “confident” or “very confident” they can maintain the level and quality of services over the next six months within the resources available.
While there is good progress to deliver the short term plan to eliminate provider deficits, trust leaders share the NAO’s concern that there is no sustainable plan to cope with the sharply lower NHS funding increases of the next four years. Almost half (49%) of chairs and chief executives think their trusts’ financial position will deteriorate in the next six months.
Trusts are struggling to meet a series of workforce challenges including shortages in key specialties and rising pressure on staff. More than half (55%) of chairs and chief executives say they are “worried” or “very worried” about whether their trust has the right numbers, quality and mix of staff to deliver high quality healthcare. Most expect this to deteriorate over the next six months.
NHS Providers chief executive, Chris Hopson, said: “NHS trusts tell us they are facing the biggest challenge in a generation.
“We need greater honesty and realism about what can be delivered for the funding and staff capacity that is available. We need a smaller set of key priorities, more support for staff, and a better relationship between trusts, the government and its arm’s length bodies to develop solutions to these challenges. We need to recognise that complex transformation will take time when set alongside an increasingly stretching task to deliver high quality patient care day to day.”
Dr Mark Porter, BMA council chair, commented: “With services struggling to keep up with demand, waiting times too high and a shortage of staff and resource, we desperately need a plan to put the NHS on a sustainable, long-term footing. We need the government to face up to reality and commit to invest what is desperately needed.”