A briefing published today by NHS Providers is urging health leaders not to draw false comfort from the noticeable absence of stories about ‘winter pressures’ in the media earlier this year. 

The real story of winter argues that although our national preoccupation with Brexit has diverted attention away from other vital challenges, performance against key standards continue to show the NHS remains in perpetual winter.

The briefing highlights the improvements trusts and their staff managed to make to winter resilience planning, and in ensuring more joined-up working between health and care services.

Combined performance data shows a widening gap between the demand for care and the capacity of the service – in terms of staff and beds – to meet it.

   

However, it also sets out the growing pressures facing our health and care services.  An analysis of NHS England and NHS Improvement combined performance data shows a widening gap between the demand for care and the capacity of the service – in terms of staff and beds – to meet it.

The NHS is now treating more patients than ever. Over winter:

• There were 6.1 million accident and emergency attendances, an increase of 5% from the previous winter and a 16% increase since 2014/15.
• The NHS admitted 1/6 million emergency cases, a rise of 6% from the previous winter and up nearly a fifth (16%) since 2014/15.
• On average, 66,300 people were being admitted in England each day over winter.

Much milder weather, with a less severe strain of flu and a significant reduction in the prevalence of norovirus, should, on the face of it, have eased some of the pressures.  

However over the winter months, we saw the worst A&E performance against the four hour target since records began, and the poorest performance recorded against key cancer standards. Moreover, the elective care waiting list is at record levels, with more people waiting longer than the recommended 18 weeks for routine operations.

Ahead of next winter, the NHS is trialling a new set of standards. But this is more difficult when performance is slipping against existing goals.

The director of policy and strategy at NHS Providers, Miriam Deakin said:

“Trusts and their staff worked incredibly hard to deliver timely care to patients over the winter months considering the huge pressure they were under.

“Although an ‘NHS crisis’ did not hit the media headlines this winter like it did last year, performance across the sector was comparable to that of last year.  In fact despite the best efforts of trusts and their hard working staff, at times, patients experienced unprecedented dips in performance.

Although an ‘NHS crisis’ did not hit the media headlines this winter like it did last year, performance across the sector was comparable to that of last year.

Miriam Deakin    

“The real story of winter is that health and care services remain overstretched, and NHS staff are now working incredibly hard throughout the year to meet high levels of demand.

“Improvements to winter preparations and the plans put in place by trusts including the use of walk-in centres, improvements in ambulance handover times and reductions in the length of stay in hospital played a key part in providing the right level of care to patients as quickly as possible.  These improvements are testament to the dedication and commitment of colleagues at the frontline.

“But it is striking how many more patients have been seeking emergency care over winter and how this pressure on A&E is having a knock-on impact on wider health and care services.

It is striking how many more patients have been seeking emergency care over winter and how this pressure on A&E is having a knock-on impact on wider health and care services.

Miriam Deakin    

“Trusts will be continuing to learn lessons from winter performance as the turn their attention to planning for the coming year.

“The ongoing clinical standards review will play an important part in how access to services is measured in future. It is right to review our approach to ensure it meets clinical practice.  However we must ensure change is not recommended simply because the service is struggling to deliver existing targets.  We must base any proposals for changing constitutional targets on an evidence-based consensus and take the time to operationalise any new standards safely and effectively.”