Pressure slides (sources)

And demand is rising…pressure_plan_v02-02

It is possible to get a fairly accurate View on the size of demand for hospital services. NHS England regularly collect figures on the level of hospital activity. These include details of the number of patients attending accident and emergency departments. It is however more difficult to estimate demand for GP services as statistics are not collected centrally. NHS England have extrapolated fun ride is precious at a constant rate of increase from the last Data collected back in 2008. This provides the basis of the estimates on this slide


But funding is not keeping up…

pressure_plan_v02-03Government spending on the NHS from 2010 to 2015 rose at just 0.9% a year in real terms under the coalition government according to analysts at The Health Foundation and The Kings Fund. This is a lot less than the average real terms increase of 3.7% per year since the NHS was created in 1948 and it is way below the average increase of 8.6% per year between 2001/02 and 2004/05.


The government also adds pressure…

During the previous parliament (2010-15) the NHS had to deliver £20 million in savings as part of what was known as the
‘Nicholson Challenge’. This was largely achieved using a combination of pay restraint, cuts to central budgets, cuts to the payment tariff, and the abolition of some regional and local tiers of management.

From 2015/16  to 2020/21 the government is demanding the NHS make £22 billion in efficiency savings. According to Kings Fund analysts, based on the organisation’s regular survey of NHS financial directors, the NHS is highly unlikely to achieve this target. 


Adds costs…

pressure_plan_v02-04PFI – the total cost to the NHS of the hospitals built through PFI (public finance initiative) is £70.5 billion, according to research from the NHS Support Federation. In 2015 the bill for PFI hospitals was £2 billion;

NHS reorganisation – It has been estimated that the reorganisation of the NHS based on the Health and Social Care Bill 2012 has cost the NHS £3 billion;

NHS Marketisation
–  The recurrent, annual costs of the market can be estimated (conservatively) at £4.5 billion, according to the
Centre for Health and Public Interest.


And makes cuts…

Mental health

Between 2010/11 and 2013/14 there was a 7% reduction in acute psychiatric care beds (The Commission on Acute Adult Psychiatric Care 2015). In addition, funding for mental health services provided by trusts has fallen by more than 8% in real terms from 2010 to 2015, according to research by Community Care and BBC News.

Adult social care

According to a report by the Association of Adult Social Services published in June 2015, around 420,000 fewer people received social care support over the past five years; councils have cut £4.6 billion from adult social care budgets since 2009/10, equivalent to almost a third of net real terms spend.

Public health

In May 2015 £200 million was cut from the budget for public health, leading to a 7% reduction in public health budget for every council. Then in November 2015 the Government announced that public health spending will be cut by 4% a year in real terms, as part of the spending review. Total spending on public health will fall from £3.4 billion in 2015/2016 to £3.1 billion in 2020/2021.


Now there is a financial crisis…

Quarter three 2015/16 figures for NHS trusts show that 179 or 75% of NHS trusts are in deficit. These trusts, according to The Health Foundation, reported a combined deficit of almost £2.3 billion and this is projected to reach £2.8 billion by the end of the financial year.


Patients experience worse care…

Government figures show that the number of people having to wait at least a week to see their GP rose by 500,000 in 2015. About 14.2 million patients had to wait a week or did not get an appointment at all the last time they tried to see their doctor in 2015, compared with 13.8 million the year before.pressure_plan_v02-20

The latest performance data for A&E from January and February 2016 were the worst since the records began, with only 83% of patients who attended A&E being seen within four hours in January and 81.6% in February, way below 95% target level.

According to the NHS Staff Survey 2015, 37% of staff report feeling unwell due to work related stress in the last year. While one in four (25%) reported experiencing musculoskeletal problems due to their work.


Staff know it to…

NHS Staff Survey 2015 found that almost 50% of staff disagreed or strongly disagreed with the statement that “there are enough staff at my organisation for me to do my job properly”, and only 43% felt able to manage all the conflicting demands on their time.