Prepare for a catastrophic NHS winter meltdown

The NHS is on the brink of a major, messy failure. If nothing is done to address the underlying issues now, the failure will be deep with grave consequences and a long recovery. This winter things are set to go catastrophically wrong.

Pressure on health services normally reduces in summer, often producing undue optimism about how they will cope come winter and delaying necessary preparations. Last summer there was virtually no reduction in pressure. Oddly, this failed to dent the optimism. The revised story was that unrelenting pressure had become a year-round phenomenon, so increased numbers and longer waits were now normal and the coming winter wouldn’t be any worse.

Unfortunately it was, the worst in 20 years. Demand for healthcare had simply reached a new (summer) plateau, with new peaks of winter demand inevitable and predictable – but not predicted and not prepared for. Waits and delays soared, even though demand increased modestly, following a well-established trend.

The crisis happened because the NHS starved itself of the capacity it needed, in the futile belief that lack of supply would constrain demand and so save money. This led not only to running out of spare capacity, but to shortages and the loss of the elasticity to cope with new peaks in demand. The result was waits and delays multiplied rather than increased, and it contributed to the worst NHS deficit in a decade.

Despite this, the lesson has not been learned that the NHS’s struggles this summer foreshadow a meltdown this winter.

Full story in The Guardian 23 September 2015