The National Health Service (NHS) is facing significant challenges despite having more staff and funding than ever before, according to a damning report by the National Audit Office (NAO). The report, titled ‘Access to Unplanned or Urgent Care,’ reveals that patient satisfaction and access to urgent treatment are worsening, with long ambulance and emergency department wait times. The report highlights the high bed occupancy rates due to delays in discharging medically fit patients as a major issue affecting efficiency.
The NAO report provides an overview of the NHS services available for urgent, emergency, or non-routine health needs. It mentions that the NHS received £100.4 billion in funding in 2010/11, steadily increasing until 2019. In 2020, the NHS received £129.7 billion for its usual services, with an additional £18 billion to tackle the pandemic. The Treasury has allocated £136.1 billion in core funding for the NHS in 2021/22, alongside £3 billion for Covid recovery. However, despite this increased funding, the NHS is struggling to improve services and has experienced a decline in productivity since the onset of the pandemic.
The report indicates that A&E attendances have increased from 21.6 million in 2011/12 to 25.2 million in 2022/23. The number of full-time equivalent NHS staff, including those working in planned or urgent care, has increased by 32.4% from June 2013 to February 2023. However, despite these increases, patient satisfaction and access to services have worsened.
The report mentions that hospital bed occupancy has reached record levels, with 92.3% occupancy between January and March. The NHS has been unable to meet key operational standards for unplanned or urgent care for several years. The target of admitting, transferring, or discharging 95% of A&E patients within four hours has not been met since July 2015. Similarly, the NHS has not achieved the target of completing all ambulance handovers within 30 minutes since November 2017.
Additionally, ambulance response times for Category 2, 3, and 4 incidents have increased since February 2021, reaching record highs in December 2022. The number of nursing vacancies remains high, despite an increase in the headcount of full-time equivalent adult nurses. GPs are also overwhelmed due to the pressures of an aging population, lack of funding, and a shortage of doctors.
Meg Hillier MP, Chair of the Committee of Public Accounts, highlights that patient access to urgent and emergency care has been deteriorating for some time, even before the pandemic. She emphasizes the need for the Department of Health and Social Care and NHS England to address these long-term trends and provide patients with the service they deserve.
The report reveals that the number of A&E patients waiting longer than four hours for admission to wards reached an all-time high in December 2022. This has limited ambulance services’ ability to transfer patients, resulting in an increase in ambulance handovers exceeding 30 minutes. Ambulance response times for Category 2 incidents have also increased since 2018.
The report concludes by mentioning NHS England’s two-year plan to improve patient experiences in urgent and emergency care services through increased capacity, workforce growth, improved discharge processes, better coordination of care outside of hospitals, and easier access to appropriate care. However, the NAO emphasizes the significant challenges ahead.
In response to the report, an NHS England spokesperson acknowledges the increase in demand for healthcare and the challenges faced by NHS staff. They highlight the significant improvements in performance since the start of the year and the implementation of recovery plans for urgent and emergency care and primary care.
A spokesperson for the Department of Health and Social Care emphasizes their efforts to achieve sustainable improvements in emergency waiting times and mentions initiatives such as adding 800 new ambulances and increasing hospital capacity with 5,000 additional beds. They also mention the provision of tens of thousands more GP appointments.
In conclusion, the NAO report sheds light on the challenges faced by the NHS despite increased staff and funding. The report calls for action to address inefficiencies in the system and improve patient satisfaction and access to urgent care services.
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