NHS is struggling more NOW than during Covid, its boss says


The boss of the NHS has claimed the service is under more pressure now than during the pandemic as she tries to plug a £7billion funding gap.

Amanda Pritchard confirmed she is negotiating with ministers for more money, saying: ‘They are aware that NHS budgets will only stretch so far.’

But Labour on Wednesday warned the NHS will cease to exist if governments keep pouring in more taxpayers’ cash without reform.

Wes Streeting, the shadow health and social care secretary, said the way the service currently functions is too expensive and must change.

Health officials are seeking to close a £7billion shortfall next year, which has been fuelled by soaring inflation and staff pay rises.

Mrs Pritchard, chief executive of NHS England, said the health service is likely to remain stretched for months and years to come.

She told a conference of health leaders it is difficult ‘not to be realistic about some of the challenges’ the NHS faces.

A record 7million people in England – one in eight of the population – are currently on waiting lists and there are fears the backlog could keep rising until 2025.

Hospitals are battling to bring the numbers down in the face of widespread staff shortages, with around one in ten posts unfilled.

HM Treasury data shows the NHS received £100.4billion in 2010/11 and its budget had grown steadily until 2019. In 2020, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service is set to receive £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery

Amanda Pritchard

Rishi Sunak

Amanda Pritchard (left) issued her stark warning as she confirmed she is negotiating with ministers for more funding. Rishi Sunak (right) told a Cabinet meeting yesterday that while other departments should expect cuts, the Government will ‘always support’ the NHS, which will ‘continue to be prioritised’

Speaking at the King’s Fund annual conference, Mrs Pritchard said: ‘When I started this job, I think I said at the time I thought that the pandemic would be the hardest thing any of us ever had to do.

‘Over the last year, I’ve become really clear and I’ve said a number of times, it’s where we are now – it’s the months and years ahead that will bring the most complex challenges.

‘And that isn’t to take anything away, by the way, from just how tough particularly some of that early period of the pandemic was.

‘But it’s definitely proving to be the case, I think it is harder now. Why? Because, partly, we no longer have a single unifying mission.

‘Instead, we are dealing with paradoxes, we’re dealing with complexity and we are dealing with uncertainty.’

Last month, the care regulator said the health and care system had become ‘gridlocked’ – with just two in five patients able to leave hospital when fit to do so due to delays arranging a care home place or home help.

The crisis has fuelled ambulance delays, with heart attack and stroke patients waiting almost an hour for a response, and vehicles stuck queuing outside A&E departments waiting to offload patients.

Mrs Pritchard said she does not believe patients always get the care they deserve, adding: ‘It’s the question that’s most likely to keep you up at night, it’s most likely to motivate you in the morning.

‘We know we’ve got a job to do, particularly on maternity services, but not just that, inpatient services for people living with learning disabilities with autism or with severe mental illness.’

Mrs Pritchard told the delegates the health think tank that the NHS had already found efficiency savings worth billions of pounds. However, there is still a gap of around £7 billion.

She admitted the NHS was ‘not in a unique position’ when it came to battling the effects of inflation, which is five-times greater than health service officials had accounted for.

But she said: ‘There is no doubt there is a job of work to do – to work through the implications of inflation and that is something that we’re in conversation with government about at the moment.

The NHS waiting list for routine operations has breached 7million for the first time ever. This includes almost 390,000 patients who've been forced to wait over a year for treatment

The NHS waiting list for routine operations has breached 7million for the first time ever. This includes almost 390,000 patients who’ve been forced to wait over a year for treatment

Ambulances took an average of 47 minutes and 59 seconds to respond to category two calls , such as burns, epilepsy and strokes. This is more than twice as long as the 18 minute target

Ambulances took an average of 47 minutes and 59 seconds to respond to category two calls , such as burns, epilepsy and strokes. This is more than twice as long as the 18 minute target

A&E waits have also breached a record, with the number of patients facing 12-hour waits exceeding 30,000

A&E waits have also breached a record, with the number of patients facing 12-hour waits exceeding 30,000 

WHAT DOES THE LATEST NHS PERFORMANCE DATA SHOW? 

More than 7million people in England were waiting for routine NHS ops in August such as hip and knee replacements.

Leading experts fear the ‘grim milestone’ — the equivalent of one in eight people — will only get topped as the pressures of winter, Covid and flu kick in.

The backlog is up from 6.8million one month earlier and marks the highest total since NHS records began in 2007. Almost 390,000 patients have been forced to endure year-long waits for their treatment, often while in serious pain. 

Separate analysis suggests the NHS is carrying out fewer operations and treatments than before the pandemic, despite pledges to shrink the ever-growing list.

‘They are aware that NHS budgets will only stretch so far.’

She added: ‘Some of the challenges, stepping up to rising inflation are well-rehearsed in our national discussion.

‘Nobody is stepping back from the commitments that have been made.

‘So the last spending review, the NHS committed to roughly twice the level of efficiency than we’ve been asked to do previously.

‘So that’s £12 billion over a three-year period.

‘Due to some other pressures that we’ve absorbed this year that means we’re actually on track right now for £5.6 billion in year.’

Mrs Pritchard has previously used far bolder language, telling colleagues that the financial situation was a ‘f—–g nightmare’.

Speaking at the same conference in central London, Mr Streeting said: ‘If the answer to the NHS challenge in the long term is only ever increasing amounts of taxpayers money into a 20th century model of care, then there isn’t going to be an NHS in the future – there certainly isn’t going to be an NHS that’s publicly funded and free of points of use in the future.

‘I think that in terms of our model of care, we spend far too much money on late diagnosis and therefore, later treatment, which is more expensive and doesn’t deliver as good outcomes for patients.

‘We need to get there far earlier with earlier diagnostics and treatment, which will not only deliver better outcomes for patients but better value for money for the taxpayer.’

NHS England now estimates there are 5.5 million people on waiting lists, rather than the 7million figure they reported last month.

Sir Jim Mackey, the NHS boss responsible for tackling the backlog, revealed the updated figure for the first time, saying the 7million number is thought to include duplicates.

He told the conference: ‘It’s actually 5.5 million people, but seven million entries on the waiting list. There are around a million and a half people, we think, who are on multiple times.

‘So, it’s a lot more complicated than we all think.’

He said it is not clear how many were patients waiting for genuinely separate issues or procedures, and how many are wrongly duplicated of the same condition.

He also warned the health service is stuck in a ‘1940s model’ that means it carries out millions of ‘pointless’ hospital appointments.

Sir Jim said doctors spend too much time seeing patients who are recovering well instead of focusing on those who still requiring a diagnosis.

The Prime Minister told the Cabinet on Tuesday that health service spending will be prioritised as other departments face cuts.

Mr Sunak and Jeremy Hunt, the Chancellor, are planning tax rises for millions of households in the Autumn Statement on November 17, alongside spending cuts, in order to address a £50 billion black hole in public finances.

Mr Sunak said the Government ‘would always support the NHS and that they would continue to be prioritised as difficult decisions are taken on spending’.

An analysis of NHS data shows the health service is carrying out fewer operations and treatments than the pre-pandemic average

An analysis of NHS data shows the health service is carrying out fewer operations and treatments than the pre-pandemic average

While the NHS performed a record number of cancer checks, the health service continued to fail to hit targets to start treatment for the disease within two months of an urgent referral

While the NHS performed a record number of cancer checks, the health service continued to fail to hit targets to start treatment for the disease within two months of an urgent referral  

But the health service, described by campaigners as being a ‘blackhole of taxpayer cash’, will have to overhaul its spending and operate more efficiently in return for having its cash protected, Whitehall insiders claim. 

MPs and campaigners have suggested the NHS should see how it can boost funds itself, rather than demanding more cash. 

A Freedom of Information Request by the Taxpayers’ Alliance today revealed the NHS has millions of pounds worth of art that could be sold off to boost cash levels.

The data revealed that the NHS has 20,000 works of art, worth an estimated £12million. NHS trusts in Fife (2,044 pieces), the Isle of Wight (1,992) and Cambridge (1,573) hold the biggest collections.

It is unclear which artwork trusts own but many pieces were donated for the benefit of patients so cannot be sold. 

Sir Christopher Chope, Tory MP for Christchurch in Dorset, told The Telegraph that the NHS should ‘look at where they can make savings’ rather than ‘looking at their works of art’.

John O’Connell, chief executive of the TaxPayers’ Alliance, said ‘hospitals are turning into mini art galleries’.

Meanwhile, a cap on social care costs, announced by Boris Johnson last September, is expected to be delayed until after the next election as part of public spending cuts. 

Due to come into effect next October, it was going set a £86,000 limit on the people had to spend on social care before local authorities took over their bill. 

But is now expected to be pushed back by at least one year to save £1billion annually.

However, the NHS and social care will still get a £13billion uplift, which was supposed to be funded by a National Insurance rise but is now expected to be supported through other taxes. 

It comes as the crippled health service performance has stooped to record lows in recent months.

NHS hospitals are currently clogged by healthy patients who cannot be discharged due to a lack of social care staff to take over their care. Three in five patients are being kept on wards longer than they need to be.

This so-called bed blocking crisis is fuelling sluggish emergency care, with too few hospital beds available to house sick people turning up at A&E and 999 callers who are stuck in the back of ambulances.

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