The NHS in England will struggle to hit its targets to improve strained emergency services by next year, an independent spending watchdog has concluded against a backdrop of falling patient admissions.
The state of the NHS will be a key issue in next year’s expected general election and Prime Minister Rishi Sunak is anxious to demonstrate reform before voters go to the polls.
But in a report published on Wednesday, the National Audit Office said the health service was “not able to secure the full benefits” of this, despite increased staff numbers and funding.
Between 2019 and 2021, they noted, NHS productivity fell by 23 per cent, “a decline which is not echoed by a similar decline in the wider UK economy”.
Patient satisfaction with GP appointment times reached their lowest level in 2022 and satisfaction with the telephone advice service, 111, fell from an average of 88.8 per cent between 2011-12 and 2020-21 to 78.7 per cent in 2021-22, the NAO .
A two-year NHS England “recovery plan” for urgent and emergency care, backed by £2.6bn in funding, has set a target of improving patient services by next March but this will be difficult to achieve, auditors have suggested.
Gareth Davies, head of the NAO, said more people than ever are receiving unplanned and urgent care while NHS England is spending public money on the rise and employing record numbers of people.
Yet deteriorating patient satisfaction and access to services suggest that “there is no single, straightforward solution to improving a complex and interdependent system,” he added.
Despite NHS England’s plans to improve services, “long-term trends in staffing, activity, costs and performance suggest this will be a significant challenge,” he noted.
Increased employee absenteeism and infection control measures due to the Covid-19 pandemic are contributing to the decline in productivity, the NAO said.
The NHS has not met some urgent care standards for the best part of a decade. Across all A&E departments, for example, the last time the NHS met the target of admitting, transferring or discharging 95 per cent of patients within four hours of their arrival was July 2015.
Matthew Taylor, chief executive of the NHS Confederation, which represents health organizations across the country, said that while funding had increased, “it has not kept pace with historical rates and has failed to keep pace with demand for more than a decade”.
Staffing levels are “still a long way from where patients need them” and “issues remain around pay and conditions for many staff”, he warned.
The Department of Health and Social Care said the government was “working to achieve the fastest and longest sustained improvements in emergency waiting times in the history of the NHS”.
The service’s recovery plan includes getting 800 new ambulances on the road and providing 5,000 more hospital beds “as well as delivering an extra 3,000 virtual ward beds to safely care for people from home”.
NHS England said the “huge increase in demand, high bed occupancy, the ‘twindemic’ impact of Covid and flu on winter and industrial action” was undoubtedly challenging for the health service.
But there was a “significant improvement in performance since the beginning of this year”.
