Demand for NHS services soars to record levels

Relentless demand for services is driving up waiting times and exacerbating financial pressures in the NHS according to the latest Quarterly Monitoring Report from The King's Fund.

The report found that more than one million patients were admitted to hospital from A&E in the first quarter of 2016/17, with the number of patients attending A&E departments also soaring to nearly six million. This means that for each month in the first quarter of the year, there were an additional 54,000 attendances at A&E departments and 14,200 emergency hospital admissions compared to the same time last year.

The report found that increased demand for services is placing the health system under huge strain with more than 90 per cent of beds occupied by patients, well above the threshold that is considered safe. This is fuelling deteriorating performance against a number of key measures:

• in the first quarter, 9.7 per cent of patients spent longer than four hours in A&E, the highest level at this time of year since 2003/4
• at the end of June 2016 6,100 patients were medically fit to leave hospital but still awaiting discharge; this is the highest number since data collection began and an increase of 22 per cent on June 2015
• the total elective waiting list of patients continues to grow, with an estimated 3.8 million patients waiting for treatment in June 2016; this is the highest level since December 2007.

The report follows on from NHS Improvement's recent report on the performance of NHS providers for the first quarter of 2016/17. It endorses the regulator's conclusion that financial deficits among NHS providers improved compared to the first quarter of last year. However, evidence from our regular survey of finance directors indicates that NHS finances remain very fragile. Key findings include:

• nearly half (47 per cent) of NHS trusts forecasting end-of-year deficits and only a third confident of meeting the ‘control totals’ they have agreed with NHS Improvement
• a worrying decline in confidence among commissioners, with twice as many CCGs (23 per cent) forecasting end-of-year deficits than at this time last year
• 40 per cent of NHS trust finance directors and 61 per cent of CCG finance leads are concerned about meeting the productivity targets they have been set this year.

Richard Murray, Director of Policy at The King’s Fund, said:

‘Hospitals are treating more patients than ever before. Winter usually brings a dip in NHS performance, but what is striking now is that key targets are being missed all year round. This reflects the impossible task of continuing to meet rising demand for services and maintain standards of care within current funding constraints.

‘While new investment and actions taken to tackle overspending have reduced deficits among NHS providers in the first quarter of the year, it would be a mistake to suggest that the financial pressures which have engulfed the NHS have eased. Unless more is done to tackle rising demand, the ideas emerging from sustainability and transformation plans about cutting beds and reconfiguring hospitals will look even more unrealistic.’