NHS hospitals may have to start rationing treatment to the sickest patients because of cash constraints, senior health chiefs claimed today.
Health Secretary Sajid Javid, under massive pressure to make the struggling NHS more efficient, has promised that ‘every pound’ will be ‘well spent’ going forward.
But senior NHS officials have described the cost-cutting demands as ‘eye-watering’, warning they will be forced to ‘streamline’ services.
This could mean closing clinics in some areas and combining them into one, according to NHS Providers.
The body, which represents trust leaders, warned the constraints are ‘going to have an impact on the thresholds that people need to meet in order to be treated’.
Saffron Cordery, interim chief executive at NHSP, said this was already the case for mental health services, which have been notoriously underfunded for years.
Health Secretary Sajid Javid, under massive pressure to revolutionise the ailing NHS, has vowed to stamp out both ‘waste’ and ‘wokery’
The number of people waiting for routine hospital treatment in England has soared to another record of 6.36million. NHS data shows one in nine people were in the queue for elective operations such as hip and knee replacements and cataracts surgery by March — up from 6.18m in February
HM Treasury data shows the NHS received £100.4billion in 2010/11 and its budget had grown steadily until 2019. In 2020, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service is set to receive £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery
The NHS, which gets £136billion of taxpayer cash every year, is also getting an extra £12.5bn a year until 2024, funded by a controversial national insurance hike of 1.25 per cent.
Waiting lists have soared since the Covid crisis reached Britain and caused havoc on hospitals.
Biggest shake-up to NHS management in 40 years ‘doesn’t go far enough’
The Health Secretary has ordered the NHS to cut its ‘diversity and inclusion’ managers, saying their salaries could be better spent on the front line.
He has vowed to be ‘watchful of any waste or wokery’ amid concern that a £12billion a year funding boost — raised through a 1.25 per cent National Insurance hike — will be swallowed by management salaries.
Mr Javid is demanding that bosses divert the salaries of up to £115,000 to patient priorities, such as tackling a record waiting list of 6.4million people.
The action comes in response to a major independent review led by a former military chief, which found leadership in the health service was ‘institutionally inadequate’.
Sir Gordon Messenger’s report found ‘evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures’ in certain parts of the NHS and social care system that has left some staff ‘not feeling comfortable to speak up’.
Suzie Bailey, from the Kings Fund health thinktank, said plans to improve health and social care workforces are ‘to be welcomed’.
But, speaking to BBC Radio 4 this morning, she warned the report does not go far enough to address burnout and staffing shortages that pre-date the pandemic.
She said: ‘Anything that supports the health and care workforce is to be welcomed.
‘However, the elephant in the room is really the deep workforce crisis that predates the pandemic and that the Government has been quite reluctant to face up to.
‘There is a huge numbers of vacancies, staff are exhausted, they were exhausted before the pandemic.’
She added: ‘This review is welcome but my concern is will it actually address the size of the workforce crisis?
‘I think it’ll make a contribution but I don’t think it goes far enough.’
One in nine people in England are now stuck in the queue for routine treatment such as hip and knee ops. Analysts fear the toll will rise for another two years.
The NHS has also come under fire for its ‘gridlocked’ cancer system, worst-ever A&E performance times and record ambulance delays.
Despite the extra cash injection aimed to help the NHS recover from the pandemic, health chiefs have pleaded for more money to address staffing shortages.
No extra funds are being given to the health service, however.
The Government has set the NHS a target of ‘dramatically’ boosting productivity in order to claw back £4.5billion per year.
Millions of pounds are wasted every year on over-paying for basic supplies, gas and electricity deals, as well as prescribing patients pills they don’t need and salaries for management.
Mr Javid has already ordered the NHS to cut its ‘diversity and inclusion’ managers – saying their salaries could be better spent on the front line.
Department of Health officials tasked the NHS with a 2.2 per cent ‘annual efficiency requirement’ in 2022/23.
But trust bosses say the actual money-saving demands equate to around 4 per cent this year.
Ms Cordery told HSJ: ‘Trusts are starting to get really concerned about the levels of patient care, versus what they have the capacity to deliver because of what they’re being asked to achieve.
‘We might see services previously offered in a number of locations possibly being streamlined and offered in one place.
‘In some areas, [the savings ask] is going to have an impact on the thresholds that people need to meet in order to be treated.’
Pointing to NHS mental health care, she added: ‘The knock-on impact of both the financial efficiencies and also huge workforce challenges mean access to services can be constrained.’
It comes after Mr Javid, an ally of under-fire Boris Johnson, yesterday compared the NHS to the now-defunct video store Blockbuster.
Addressing a Cabinet meeting this morning in the wake of the PM’s battering at the hands of Tory rebels, he described it as a ‘Blockbuster healthcare system in the age of Netflix’.
Mr Javid demanded the public gets the ‘level of service they expect’, insisting that it was ‘no longer simply an option to stick to the status quo’.
Asked today whether his Netflix reference meant people would need to start paying for a subscription, he told BBC News: ‘Not at all.
‘I’m very proud of that we have got an NHS that’s free at the point of use, paid out of our general taxation, there for all of us when we need it.
‘But what I mean by that particular comment is it needs to modernise.
Separate data on A&E performance in April shows a record 24,138 people were forced to wait 12 hours or more to be treated, three times longer than the NHS target and the worst figure on record
Ambulance figures for April show waits for paramedics fell compared to March but were higher than nearly all other months since records began. Ambulances took an average of 51 minutes and 22 seconds to respond to category two calls, such as burns, epilepsy and strokes. This is nine minutes and 41 seconds quicker than one month earlier
England’s Covid backlog in cancer care is set to last another five years without urgent action, a leading cancer charity warned today. Graph shows: The number of patients fewer than expected to receive first cancer treatment since the start of the pandemic (red line) and how long it will take to reduce to zero if treatments continue at the current pace (dotted red line), increase 5 per cent on pre-pandemic levels (dotted green line) or increase 10 per cent on pre-pandemic levels (dotted blue line)
NHS England aims to treat 85 per cent of cancer patients who receive an urgent referral from their GP within two months, but in November 2021, the latest available, only 67.5 per cent of patients received treatment in this time frame. While the problem predates the Covid pandemic, the disruption to services caused by the virus has exacerbated the problem
‘We need to make sure that we keep modernising that we have a NHS that is looking out towards the 2048, not one that was designed for 1948.
‘And the Blockbuster analogy is that, for those those who remember Blockbuster, is it failed to modernise.
‘It failed to adapt to changing trends in markets, and therefore it wasn’t able to serve its customers and did not survive.’
Mr Javid, who took over the Department of Health last June, added: ‘No-one wants to see that kind of thing happen to something as important as the NHS.
‘That means making sure that the NHS is is looking at the latest demographics, our ageing population, the changes in the burden of disease use and also medicines and the latest technology.’
Blockbuster closed its remaining stores in the UK in 2013, after administrators were unable to find a buyer for the chain.
It had been hit hard by intense competition from supermarkets, as well as the shift from physical rental and sales to online games, music and films.