NHS funding and capacity comparison
Data for the levels of NHS staffing and hospital activity in England were sourced from NHS digital for the years 2010 and 2017.
Providers were grouped according to their current Sustainability and Transformation Partnership and the area boundaries for each were then applied to both 2010 and 2017 figures to enable a comparison.
Allowances and re-groupings were then made to the data to allow for the following factors:-
- The NHS reorganisation in 2013 which removed Primary Care Trusts and introduced Clinical Commissioning Groups which worked to new boundaries
- The introduction of new definitions and reporting methods by NHS digital in 2015, which changed the way NHS staff were categorised and recorded.
- The transfer of the responsibility for community and mental health services from PCTs to healthcare providers, mainly NHS trusts, but also independent providers.
- Some known closures - although a complete list of these is not available.
- New sites, where known
Reasons for continuing discrepancies include:-
- The transfer of NHS services to independent providers (company, charity or community interest company) where NHS staff have been moved to the new provider. This data was not included in the main workforce statistics provided by NHS Digital for the time-period.
- Providers that have significantly increased their treatment of patients from outside their area (STP footprint) in the time frame (2010-17)
- The impact of mergers and closures of departments not included in our analysis.
- The movement of staff working in public health from NHS providers to local government in 2014/15
- From 2010 to 2017, staff in this area have moved to being employed by private companies and community interest companies to undertake NHS work; these staff are not included in the data from NHS Digital. As a result, the 2017 staffing figures are lower than the actual number of staff working in healthcare in the area. In this area, NHS work is carried out by (add in companies and/or CICs).
Inconsistencies in reporting
The National Audit Office has concluded that there are inconsistencies in how hospitals record patients who receive day case emergency care. Eg Some hospitals record these patients as an emergency admission, where others do not.
The NAO also concluded that “the Department of Health, NHS England and NHS Improvement do not fully understand the reasons for the considerable local variation in the rates of emergency admissions. After controlling for demographics, deprivation, health needs, and local costs, in 2016-17, the rates of emergency admissions varied across local areas”
Data from NHS digital provided the number of GPs and registered patients in each STP.
We then applied a widely recognised estimate for the number of patients that a GP could safely see in a week to ascertain the difference between the desired number of GPs in any area and the actual number currently working.
Minimum appointments required per week = 72/1000 patients (NHSE via McKinsey, but widely accepted)
Average list size per GP = 1600 approx. (2014 NHS/HSCIC figures)
UK data was compared with statistics from the OECD data set about hospital activity and levels of staffing.
The number Beds per 1000 population in England was calculated using two sources: Figures on bed availibility in England produced by NHS Digital and the most recent ONS estimate of the population of England.
The number of beds per 1000 in the EU-15 was sourced from a Kings Fund report (2017). This rate was then applied to the English population to work out the difference between the number of available beds in England's NHS and the number that it would need in order to reach the EU level of 3.7 beds per 1000.