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NHS leaders not confident national target on resuming routine services can be met


By Awil Mohamoud
29 September 2020

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Three-quarters of NHS leaders (74%) lack confidence that their routine services can return to near-normal levels by the end of October, in line with the national target, an NHS Confederation survey has found.

The survey of 250 chief executives, chairs and clinical leaders working in secondary and primary care also found 88% believe a lack of funding will be a ‘significant barrier’ to meeting waiting time standards for patients.

In its report on the findings, the NHS Confederation warned of a ‘long road’ ahead and said services now face a ‘triple whammy’ in having to deal with local outbreaks and a second surge of Covid-19, while managing a ‘huge backlog of treatment’ and restoring services – all despite reduced capacity and staff exhaustion.

The report, which looked at reshaping the health and care system after Covid-19, concluded that ‘the NHS is ambitious in its aims to restore services for patients’, but there is ‘little confidence’ that it will be possible to do so in the short term across primary, acute and community services.

The most positive picture seems to be around the restoration of cancer services, the report said, with around half of acute providers and ICS’ expressing ‘some confidence’ in being able to resume these services. 

NHS performance figures for June showed almost half of patients referred for NHS treatment were waiting more than 18 weeks to be seen, while 3.9 million people were on waiting lists.

The report identified ‘huge progress’ made in restoring services to previous levels in recent months, but said that the pandemic’s impact on the capacity of the NHS is likely to go on for ‘several years’.

It said: ‘The [health] service needs government investment to support new ways of working that will enable it to fully and safely restore services, as well as the understanding of the public while it adjusts and deals with a large backlog of patients needing care. Political leaders will need to help manage public expectations about what is possible.’

Funding

The NHS Confederation also called on the Government to revisit the NHS’ 2018 five-year funding settlement – worth £20.5bn and set out in the November spending review – to provide additional revenue to cover the rising demand and enable services to catch up with the backlog of treatment.

The expected surge in demand for mental health services will also require additional resources, the body said, and a long-term funding settlement for the social care system also needs to be agreed.

One NHS leader told the Confederation: ‘It is not possible to plan diagnostic services without knowing how many MRI scanners you will have.’

The report urged politicians and national bodies to support the NHS to manage the realities of recovering services, rather than setting unrealistic targets and imposing financial penalties.

‘In particular, the [health] service needs a multi-year settlement to give it certainty and enable it to plan and invest for the future,’ it said.

‘Time for bold investment’

Lord Victor Adebowale, chair of the NHS Confederation, said: ‘Covid-19 has been the biggest disruptor in the NHS’s history. Out of necessity, it has transformed patient services in ways previously unimagined and changes that would usually take years have been delivered in weeks.

‘This is the moment for the Government to grasp the nettle, be bold and invest in a health and care system not just for this winter but for the long term. It must be reimagined in a way that lets local leaders deliver services that work for everyone in their communities.’

He added: ‘Above all, we need to see a radical and conscious shift in every part of the country towards tackling health inequalities. If there is one lesson from the pandemic, it is that our universal health service does not care for everyone equally.’

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