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Hospitals are said to be under such strain that some patients who have waited months for surgery are having it cancelled at the last moment. Photograph: Claire Cordier/Getty Images
Hospitals are said to be under such strain that some patients who have waited months for surgery are having it cancelled at the last moment. Photograph: Claire Cordier/Getty Images

NHS ‘creaking at seams’ as A&E delays pressurise other hospital departments

This article is more than 9 years old
Patients having to wait longer for cancer treatment and planned operations, minsters are warned by King’s Fund thinktank

The NHS is “creaking at the seams” with problems spreading from A&E units to other parts of hospitals, forcing patients to wait longer for cancer treatment and planned operations, ministers are warned on Thursday.

The health service is under such pressure that it is now in a critical state and services are stretched to the limit, according to the King’s Fund’s latest assessment of NHS performance.

The influential thinktank’s withering analysis of the decline in the ability to meet key waiting-time targets and its worsening financial state says the NHS is struggling to cope with the growing demand for care and an unprecedented squeeze on its budget.

The recent deterioration is so serious that it is increasing the risk of a full-blown health service crisis, the fund says.

Dr Mark Porter, the leader of the British Medical Association (BMA), said hospitals were under such strain that some patients who have been waiting weeks or even months for surgery are having it cancelled just before they are taken into theatre.

The King’s Fund reached its stark conclusions after analysing an array of data indicating how the NHS in England fared in the last three months of 2014.

Prof John Appleby, the fund’s chief economist, said: “While recent attention has focused on the problems faced by A&E units, performance against waiting time targets and other indicators has continued to worsen.

“Taken together, the findings from this quarter’s report show that services are stretched to the limit.

“With financial problems also endemic among hospitals, and staff morale a significant cause for concern, the situation is now critical.”

Doctors’ and nurses’ leaders said the findings in the latest King’s Fund quarterly overview of the NHS, underscored their concerns about the service.

Porter, chair of council at the BMA, said that A&E units’ failure to hit their key waiting-time target of treating 95% of arrivals within four hours reflected the “wider pressures” being felt across other services.

“Every part of the system – from general practice, to hospitals, to community care – is struggling to keep up with demand, leaving some patients facing unacceptable delays for treatment.”

Dr Peter Carter, chief executive of the Royal College of Nursing, said: “The NHS is struggling and stretched far too thinly.”

The thinktank had found “a lack of investment, poor workforce planning and fragmented services have affected patients across the whole NHS”, he added.

The King’s Fund also found that:

The NHS had received just 0.8% more money in real terms year-on-year, but was seeing bigger rises in the numbers of patients turning up at A&E (up 1.8%), having planned surgery (2.8%) and needing to be admitted as an emergency (1.8%).

More than 5,000 hospital beds a day are now occupied by patients who are medically fit to go, deepening bed shortages and making it harder to admit patients arriving through A&E.

The number of operations cancelled due to bed shortages was recently a third higher than a year previously.

Separate research by the thinktank among finance directors of NHS organisations revealed that 60% of NHS trusts are relying on bailouts from the Department of Health or using their reserves in order to stay afloat, and that next year’s financial picture looks even worse.

Despite the King’s Fund’s gloomy prognosis the health department simply reiterated that it had given the NHS extra money to cope with this winter.

“The NHS is busier than ever which is why we have given almost £1bn this year for almost 800 more doctors, 4,700 more nurses, 6,400 more beds and treatment for an extra 100,000 patients”, said a spokeswoman.

“We are backing the NHS’s plan for the future and have provided an extra £2bn in funding next year to transform out of hospital care and expect trusts to have strong financial grip to help achieve this.”

More on this story

More on this story

  • NHS hires up to 3,000 foreign-trained doctors in a year to plug staff shortage

  • A&E waiting times in England improve as attendances tumble

  • NHS hiring drive hurts Hungary but India can cope with doctor exodus

  • Labour blames coalition cuts for huge increase in A&E patient numbers

  • Cameron distances government from revised NHS major incident guidelines

  • Councils get emergency £25m for social care to tackle hospital blockages

  • Working in A&E is a privilege even if it is stressful and understaffed

  • How to solve the crisis in London’s A&E departments

  • Pharmacists could hold the key to solving A&E crisis

  • It’s time to call in charities to ease A&E winter pressures

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