Honesty over the scale of NHS challenges needed

NHS Providers is warning that a failure to present the public with the true scale of the challenges facing the NHS risks putting public faith in the health service 'on the line'.

NHS Providers’ report The state of the NHS provider sector sets out in detail the growing pressures and difficulties trusts face, despite welcome funding pledges from government and a new long term plan for the NHS.

A recent survey showed that 91 per cent of trust leaders do not feel there has been enough public debate about the challenges and opportunities facing the NHS and its long-term future. NHS Providers says that patients and taxpayers deserve ‘honesty, realism and transparency’ about how much the NHS can deliver, and how quickly, given how far current NHS performance has dropped, 100,000 staff vacancies, an underlying £4 billion provider sector financial deficit, a £6 billion maintenance backlog and no firm decisions on social care, public health, capital and training budgets.

The survey also revealed that only 29 per cent of trust leaders are confident that their trust currently has the right numbers, quality and mix of staff in place to deliver high-quality healthcare to patients and service users, with 90 per cent worried about a lack of investment in social care in their local area.

The organisation calls for a funded, credible final NHS workforce plan which addresses recruitment, training, culture and inclusion, as well as greater clarity on the quality standards the public should expect along with the resources to deliver them. The report also says that a proper, full, multi-year capital settlement and appropriate sustainable funding for social care and public health is necessary to being about sustainable change.

Chris Hopson, NHS Providers chief executive, said: "It is very striking that over 90 per cent of trust leaders are worried that there hasn’t been the full, frank and open national conversation about the severe pressures facing the NHS and how much these constrain what it can deliver. It’s an uncomfortable debate to have. The government wants to be seen as an effective steward of the NHS. NHS England and NHS Improvement want to be seen to lead the service effectively. And frontline leaders want to provide outstanding care to every patient. But we need greater realism about how much the NHS can deliver, and how quickly, given where we currently are and the challenges we face.

"It’s great that the new government has made the NHS its top domestic priority. Trusts have welcomed increases in funding compared with other public services and the ambitious plan for the next decade. But the NHS faces a triple whammy of rapidly rising demand, severe workforce challenges and the need to recover from the longest and deepest funding squeeze in NHS history. Current performance levels are the worst in a decade and trying to work NHS staff harder and harder is simply not sustainable.

"Unless we level with the public about how long it will take to recover from where we are and how quickly we can deliver the NHS long term plan, public commitment to the NHS is on the line. NHS leaders are sending a clear signal that we need an honest, realistic and transparent view of the difficult choices and challenges – as well as the exciting opportunities – that lie ahead."

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