Professor Ted Baker, the new Chief Inspector of Hospitals for the Care Quality Commission (CQC) has voiced concerns about unsuitable antiquated models of care in the NHS (due to a historic 15-20 year mis-direction of funding), growing pressures for urgent and emergency hospital care, problems with staffing levels and recruitment, and increasingly squeezed NHS capacity.
NHS ‘not fit for 21st Century’, says chief hospital inspector. London: BBC Health News, September 30th 2017.
The Royal College of Nursing has reported similar concerns from front-line nursing staff:
Triggle, N. (2017). NHS staff shortages ‘mean patients dying alone’ in hospitals. London: BBC Health News, September 29th 2017.
Earlier “doom and gloom” laden projections:
Triggle, N. (2017). The worst is yet to come for the NHS – hospital chiefs. London: BBC Health News, September 3rd 2017.
Further BBC News commentary:
Pym, H. (2017). As winter looms, NHS debate warms up. London: BBC Health News, September 7th 2017.
Possibly of interest, a recent King’s Fund briefing indicates that the number of NHS hospital beds in England has roughly halved over the past 30 years. Questions are raised about the feasibility of further proposed bed reductions.
Ewbank, L. Thompson, J. [and] McKenna, H. (2017). NHS hospital bed numbers: past, present, future. [Online]: King’s Fund, September 29th 2017.
Rising Delays in Emergency Department Admissions?
The number of patients waiting more than 12 hours for admission in emergency departments has increased a hundred-fold over the past five years, according to the BMA using data obtained by the Royal College of Emergency Medicine (RCEM):
Delays rise a hundred-fold. [Online]: British Medical Association (BMA), September 27th 2017.
Trends in Hospital Admitted Patient Care Activity (2016-17)
In 2016-17 there were 16.5 million recorded Finished Admission Episodes (FAEs); an increase of 1.8% from the previous year and an increase of 27.5% since 2006-07. Finished Consultant Episodes (FCEs) for the 65-84 year old age group have increased fastest over the last ten years.
Hospital Admitted Patient Care Activity: 2016-17. London: NHS Digital, October 3rd 2017.
A briefing from the NHS Confederation outlines the challenges facing the NHS and suggests how MPs and other parliamentarians might support the health service at national and local levels.
Healthcare on the brink: how parliamentarians can support their local NHS. NHS Confederation briefing; Issue No.300. London: NHS Confederation, September 26th 2017.
The Latest CQC Report
The Care Quality Commission (CQC) has alleged that parts of the NHS may soon be “straining at the seams” and facing a “precarious” future”.
Triggle, N. (2017). NHS future precarious, says regulator. London: BBC Health News, October 10th 2017.
On the Positive Side
The NHS has prepared specially for Winter this year – more so than ever before – and ongoing demands for additional funding / hospital bailouts have not gone unheard.
Earlier this month, 19 hospitals across England were awarded £13 million for emergency care, with the explicit aims of improving patient flow in A&E departments and achieving better preparedness for high Winter demand.
New £13 million funding to help hospital A&Es prepare for winter. [Online]: Department of Health, September 8th 2017.
National Service Specification for Integrated Urgent Care Services
The NHS England national service specification defines an alternative model of service delivery (said to move from an “assess and refer” to a “consult and complete” model). This involves an outline for an Integrated Urgent Care Clinical Assessment Service (IUC CAS). The IUC CAS is intended to ensure patients accessing health services always receive a complete episode of care, involving receipt of either advice, a prescription, or an appointment for further assessment and / or treatment.
NHS England’s Integrated Urgent Care Delivery Team (2017). Integrated Urgent Care Service Specification. Leeds: NHS England, August 25th 2017.
Safety and Quality in Emergency Care: Best Practice
Professor Ted Baker (see above) has released a letter to NHS trusts in England which summarises points of good practice (as taken from successful emergency care departments in 16 trusts rated good or outstanding). The main themes identified are:
- Ambulance arrivals.
- First clinical assessment.
- Non-use of inappropriate physical spaces.
- Specialist referrals.
- Deteriorating patients.
- Patient outcomes.
Safety and quality of emergency care. [Letter from Ted Baker to NHS trusts about emergency care]. London: Care Quality Commission (CQC), September 29th 2017.
Further details to follow.