NHS 'winter crisis' will last into August amid unprecedented funding pressure, BMA warns

Little chance of hitting waiting times targets during summer lull with pressures akin to December 2016

Alex Matthews-King
Health Correspondent
Monday 02 April 2018 00:40 BST
Thousands protest in London over NHS crisis

The NHS winter crisis is now a year-round problem with bed pressure and delays during the summer “respite” likely to be as bad as in the depths of December two years ago, according to a new analysis.

The British Medical Association (BMA) has said NHS staff now work flat-out all year round and summer months that used to bring extra bed and staff capacity are spent managing the fallout of “massive spikes in demand”.

After the worst winter in recorded history, where senior doctors warned patients were “dying prematurely” in corridors, BMA council chair Dr Chaand Nagpaul said every year these issues “stretch further into spring”.

“We cannot accept that this is the new normal for the NHS,” he said.

The unprecedented decision to cancel thousands of non-urgent operations and appointments this winter could make summer 2018 particularly challenging, the BMA added.

Some hospitals, such as University Hospitals North Midlands, have already committed to extending their winter contingency measures through to summer to cope with the expected demand.

Compiling official data from the past five years and extrapolating it ahead to the July to September period the BMA warns that at their worst pressures could be on par with the winter 2016.

It says 774,000 patients are likely to wait more than four hours at A&E.

With 6.2 million patients expected to show up at emergency rooms it means just 87.5 per cent will be seen, treated or sent home within four hours – well short of the national target of 95 per cent of patients.

It also predicts that more than 147,000 people will be kept waiting on trolleys for more than four hours after doctors have identified they need a bed.

Even in the best case – comparable to 2015, the last time the four-hour target was hit – the BMA still expects more than one in 10 patients to wait longer than four hours at A&E.

This is despite the government allocating an additional £1.6bn for 2018/19 in the Autumn Budget for the express purpose of tackling waiting times and achieving the targets again.

The additional funding was less than half the £4bn that experts said is the minimum needed to keep services running, let alone make improvements.

An additional £335m for last winter was also given in the budget but it failed to avert the cancellation of all non-urgent care in January.

Academics have warned there were 10,000 more deaths in the first weeks of 2018 than would be expected and needed to be investigated.

“This data clearly shows what doctors working on the front line have been saying for some time – that the “winter crisis” has truly been replaced by a year-round crisis,” Dr Nagpaul added.

“This research proves that this approach of cash top-ups and short-term fixes will no longer do, Dr Nagpaul said.

UK health spending is at least £7bn a year behind comparable European countries and long-term funding hinted at by ministers needed to reach the front line "urgently".

The prime minister, Theresa May, suggested last week that her government was working up plans for a long-term deal for the NHS, though she provided no further details.

Under the Conservatives, health service funding has increased by just one per cent a year on average, compared to around four per cent a year which has been typical for the rest of the NHS’s history.

Justin Madders MP, Labour’s Shadow Health Minister, said: “These are extremely concerning projections, which will deeply worry patients and staff emerging from the worst winter crisis on record.

“Despite the very best efforts of our hardworking NHS staff, eight years of starving our health system of the funds it needs is resulting in chaos all year round. In one of the richest nations in the world this is simply unacceptable.”

A Department of Health and Social Care spokesperson said: “We know that demand continues to grow, and that staff have never worked harder, which is why we gave a pay rise to more than 1.2 million dedicated staff, and why we supported the NHS with an extra £2.8bn, on top of a planned £10bn a year increase in its budget by 2020/21.

“The prime minister and health and social care secretary have committed to a fully funded, long-term plan for the NHS, which will be agreed with NHS leaders, clinicians, and health experts.”

The pay deal announced in March will make rises of as much as 29 per cent are a possibility for a small number of staff in the next three years and increase the base rate of 100,000 lowest paid workers above the living wage.

However around half of staff, the most experienced and long-serving in their roles, will see a maximum pay rise of 6.5 per cent which some unions are warning will not keep up with inflation and should be rejected.

NHS England previously said this winter has been a "perfect storm" of appalling weather, persistently high hospital admissions due to flu and a renewed spike in norovirus.

An NHS England spokesperson said: "The NHS has faced continued pressure after one of the coldest March months in 30 years.

"Over the decade ahead our health service is inevitably going to have to respond to the needs of our growing and ageing population, which is why now charting a ten year plan for the NHS makes such sense."

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