NHS Providers: ‘Time to come clean to the public about the scale of challenges the NHS faces’

NHS Providers is warning that a failure to present the public with the true scale of the challenges facing the NHS risks jeopardising public faith in the health service

The warning follows a survey demonstrating that 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 highlights the growing pressures trusts face despite funding pledges from government and a new long term plan for the NHS.

Current NHS performance has dropped: there are 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. The report says patients and taxpayers deserve honesty, realism and transparency about how much and how quickly the NHS can deliver under these circumstances.

The report survey, which drew responses from leaders at 54% of trusts representing hospital, mental health, community and ambulance services, also reveals:

1. 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.

2. 90% of trust leaders are worried about a lack of investment in social care in their local area.

3. 77% of trust leaders are worried that there is not enough investment in public health and prevention services in their local area.

4. 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 about their ability to deliver the ambitious aspirations set out in the NHS long term plan. Worries about ‘system working’ and the merging of GP services with hospital and community care are particularly prevalent.

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Chris Hopson, chief executive of NHS Providers, said: “It’s an uncomfortable debate to have. The government wants to be seen as an effective steward of the NHS. NHS England and 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.

“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.”

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