This government report for the commons health select committee is quite a long involved piece, but if you are interested in the detail behind the headlines on NHS pressures is right now, it makes for change, it is well worth a read.

Certainly the government cannot argue that it hasn’t been made aware of the scale of the growing crisis in health services, although quite bizarrely they continue to deny it!

I have pasted some key paragraphs below…………………………..

“The British Medical Association (BMA) noted that:

Figures from January–March 2016 showed the average occupancy rate in acute and general hospitals was 91.2%, with 20% of trusts averaging 95% or above, leaving very little flexibility in the system to cope with a seasonal spike in demand.”

“In practice, the Royal College of Emergency Medicine argued, that the consequence of limiting bed capacity has been a growth in general and acute bed occupancy from 86.3% in 2010–11 to 91.2% in 2015–16.59 The College’s evidence, however, noted that this is the figure recorded at midnight—daytime occupancy rates frequently exceed 100% in many hospitals. Such occupancy levels mean there is no surge capacity, rendering hospitals hostage to fortune.”

“The increase in attendances in the last 5 years is equivalent to the workload of 10 medium sized departments in England alone–none of which have been built. Moreover, during the last 5 years the number of beds available for admission of acutely ill and injured patients has continued to fall …..

“we now have the lowest number of beds per capita in Europe and England has the lowest number within the UK.”

“Investment in ‘step-up / step-down’ community rehabilitation beds helps to relieve the pressure on NHS beds and can help to flex capacity at times of especially high demand. Nevertheless, acute trusts need to plan effectively for sufficient acute beds as well as access to community beds to improve patient flow.”
The British Geriatrics Society:

“The King’s Fund briefing Deficits in the NHS 2016 provides an up to date analysis which shows that despite transfers of NHS budget to social care it has not kept pace with the increase in demand, and the fall in social care spending between 2010–15 has led to two issues: i. people being unable to access the care they need leading to poorer health outcomes and an increased likelihood of presenting at A&E, and ii. people remaining on an acute hospital ward for longer than necessary, again with an impact on A&E departments,…..”

“We believe that adult social care is underfunded and this is having an impact on the NHS. The performance of the NHS and social care cannot be viewed in isolation. Adequate funding of social care and appropriate development of the social care workforce are worthy objectives in their own right, but the urgency of action on those two objectives is thrown into even sharper relief in the context of their contribution to the improved performance of the urgent and emergency care system.”

The full report is below:

Pic: Ottery Hospital, described as “helpful step down care” in the report.