Time to level with the public about the scale of challenges facing the NHS
08 October 2019
NHS Providers is warning that a failure to present the public with the true scale of the challenges facing the NHS risks putting public faith in the health service 'on the line'. The warning follows a survey showing that the overwhelming majority (91%) of trust leaders do not feel there has been enough public debate about the challenges and opportunities facing the NHS and its long-term future.
The findings are contained in NHS Providers’ report The state of the NHS provider sector, which sets out in detail the growing pressures and difficulties trusts face, despite welcome funding pledges from government and a new long term plan for the NHS.
The report says patients and taxpayers deserve honesty, realism and transparency about how much the NHS can deliver, and how quickly, given how far current NHS performance has dropped, 100,000 staff vacancies, an underlying £4bn provider sector financial deficit, a £6bn maintenance backlog and no firm decisions on social care, public health, capital and training budgets.
Only 29% are confident that their trust currently has the right numbers, quality and mix of staff in place to deliver high-quality healthcare to patients and service users.
The report survey, which drew responses from leaders at more than half (54%) of trusts, representing hospital, mental health, community and ambulance services, also reveals:
- only 29% are confident that their trust currently has the right numbers, quality and mix of staff in place to deliver high-quality healthcare to patients and service users
- 90% of trust leaders are worried about a lack of investment in social care in their local area
- 77% of trust leaders are worried that there is not enough investment in public health and prevention services in their local area
- 72% are concerned about whether their trust can make the capital investment needed to maintain and modernise the NHS estate and equipment. This is against a backdrop of £6bn of built-up backlog maintenance across the NHS, including £3bn that is safety critical.
Cumulatively these challenges mean that trust leaders are concerned at their ability to deliver the positive and ambitious aspirations set out in the NHS long term plan. Only 29% are confident that progress towards system working in their area will move fast enough within the next 12 months to help them deliver the plan. More than half (54%) do not believe the necessary support is in place to properly join up working between GPs and hospital and community care.
The report calls for:
- a funded, credible final NHS workforce plan which addresses recruitment, training, culture and inclusion
- greater clarity on the quality standards the public should expect along with the resources to deliver them
- a proper, full, multi-year capital settlement and appropriate sustainable funding for social care and public health
- greater realism about the scale of the challenges facing trusts and the wider health and care sector and the current level of operational instability, which place significant constraints on how quickly the new NHS long term plan can be delivered.
Commenting on the report, Chris Hopson, NHS Providers chief executive, said:
"It is very striking that over 90% of trust leaders are worried that there hasn’t been the full, frank and open national conversation about the severe pressures facing the NHS and how much these constrain what it can deliver.
"It’s an uncomfortable debate to have. The government wants to be seen as an effective steward of the NHS. NHS England and NHS Improvement want to be seen to lead the service effectively. And frontline leaders want to provide outstanding care to every patient. But we need greater realism about how much the NHS can deliver, and how quickly, given where we currently are and the challenges we face.
"It’s great that the new government has made the NHS its top domestic priority. Trusts have welcomed increases in funding compared with other public services and the ambitious plan for the next decade.
It is very striking that over 90% of trust leaders are worried that there hasn’t been the full, frank and open national conversation about the severe pressures facing the NHS and how much these constrain what it can deliver.Chief Executivetweet this
"But the NHS faces a triple whammy of rapidly rising demand, severe workforce challenges and the need to recover from the longest and deepest funding squeeze in NHS history. Current performance levels are the worst in a decade and trying to work NHS staff harder and harder is simply not sustainable.
"Unless we level with the public about how long it will take to recover from where we are and how quickly we can deliver the NHS long term plan, public commitment to the NHS is on the line. NHS leaders are sending a clear signal that we need an honest, realistic and transparent view of the difficult choices and challenges – as well as the exciting opportunities – that lie ahead."