Strikes could wipe out once-in-a-generation chance to fix the NHS

NHS Providers has warned that industrial action by resident doctors, planned for later this week, could wipe out NHS recovery, risking hard-won progress on patient care, safety and NHS finances.
 
The annual State of The Provider Sector survey of leaders from NHS hospitals, mental health, community and ambulance services has found a growing proportion of trust leaders reporting high or very high quality care for patients in their area.  
 
It also highlights a range of steps under way to improve NHS productivity, with a majority of trust leaders saying they expect their trusts to meet their financial plan, despite severe pressures. 
 
There are worries however, that imminent strikes by resident doctors - with the threat of more to come in December - would jeopardise these gains, particularly as the NHS heads into what is expected to be another tough winter.
 
The scale of the challenges trusts face remains daunting, including waiting times for patients, rock-bottom workforce morale and increasing demand for care. 
 
There are particular concerns over the priority and resources being given to mental health services, including scepticism that the government understands the scale of the challenge, and its likely impact on economic growth.
 
Key findings from the survey include:
 
•    A majority of trust leaders (52%) said the quality of care in their area was high or very high, up 11 percentage points on last year and the most positive finding on this indicator going back to before the pandemic. However the findings also revealed deep concerns over long waiting times and the need for a “fundamental shift in approach”.
•    Most trust leaders (53%) said they have the right number, quality and mix of staff. The figure for last year was 40%. However there were deep concerns about staff burnout (79%), discrimination towards staff from patients and the public (77%) and morale (74%). 
•    Even though the survey was carried out before the British Medical Association announced a further 5-day stoppage by resident doctors, nearly two-thirds of trust leaders (64%) were worried about the potential impact of industrial action.
•    Fewer than one-in-ten trust leaders (9%) agreed that investment in mental health services matched demand. More than half (60%) said mental health services lacked the capacity to reduce waits and intervene earlier.
•    More than a third of trust leaders (37%) described last winter as the most challenging of their NHS careers. 67% said they expected this winter to be tougher. However the survey shows they are putting in place a range of initiatives to ensure safe, high quality care.
 
Responding to the findings, Daniel Elkeles, chief executive of NHS Providers, said:
 
“This survey reflects a gathering sense among trust leaders that at long last, we are turning a corner.
“Nobody for one minute underestimates the scale of the problems posed by long delays, financial pressures and a relentless rise in demand for care. 
“And it’s clear that progress is uneven. Some trusts – through no fault of their own – have a bigger and steeper hill to climb. 
“It’s particularly worrying to see the depth of concern about mental health services when they’ve never been needed more.
“Trust leaders want to seize on the opportunities presented by neighbourhood working for a successful and sustainable NHS.
“But instead of going full throttle shifting care into the community, we’re moving at a glacial pace. We need to get a move on.
“We see progress on productivity that’s being driven by digital transformation and bearing down on agency costs. There’s so much more that can be delivered through AI, too.
“We see the desire for a well-supported workforce, ready and able to provide the high quality care patients deserve.
“These are key ingredients to win back public trust in the NHS.
“More strikes now could crush this fragile, hard-won progress, wiping out a once-in-a-generation opportunity to fix the health service.  
“And just ahead of the budget, let’s remember strikes come at a financial cost. That’s money the NHS does not have.
“We’re starting to shift the dial. Let’s all face forward together to build the better NHS that patients deserve.”