Doctors and nurses are “absolutely frightened and petrified” about how bad this winter will be for the NHS in England, hospital bosses have revealed.
Staff fear services will not be able to cope with a combination of flu, resurgent Covid, winter and the cost of living crisis damaging people’s health, and also the wave of looming strikes over pay.
“People are genuinely scared,” said the chief executive of one acute NHS trust in England.
“I’m talking to senior clinicians and consultants and nurses who are absolutely frightened and petrified about what’s potentially to come,” added the hospital boss, speaking on condition of anonymity. Staff are anxious because of “the potential for the impact of Covid and flu, the impact of industrial action, the impact of cost of living, the impact on people’s health from that, [and] the massive increases in mental health need, and the breakdown in primary care and social care.”
Chiefs of other NHS trusts in England said they shared that gloomy prognosis. They are bracing themselves for having to curtail and cancel services on days when staff stop work over pay, including outpatient clinics and non-urgent surgery. The NHS will face an “onslaught” this winter, one said.
Nurses at most hospitals and other NHS services across the UK are due to strike next month. Another trust boss said that while they could cope with a stoppage by nurses, a strike by members of Unison – the result of its ballot of staff is due next week – could make it impossible to keep services running at anywhere near normal levels. “Services will inevitably contract,” they said.
Six out of seven (86%) hospital bosses are worried they will not be able to meet the intense demand for care they are set to face over the next year, given growing pressures.
Similarly, 85% are more worried about this winter than any previous one, according to a survey of 183 senior figures at 121 trusts in England undertaken by the hospital group NHS Providers.
Large majorities are also concerned about a lack of staff (77%), workers at their trust suffering burnout (93%), and lack of investment in social care (94%).
The Guardian reported on Monday how up to a third of beds in some hospitals are occupied by patients who are medically fit to be discharged but cannot leave because the lack of social care locally means they are not safe to return to their own home or care home.
The boss of a hospital where about three in 10 beds cannot be used for new arrival for that reason said it was a major false economy to allow social care to become so inadequate because it costs £500 a night for a person to be in hospital but £250 for them to be in a care home and even less – £50 – for domiciliary care workers to look after them in their own home.
Meanwhile, the NHS has been challenged over how it is using its record £152.6bn budget after new research showed it is treating fewer patients in the 7.1 million-strong backlog than expected.
“NHS spending in England is, in real terms, 12% above its 2019 level. Yet it is getting fewer people off waiting lists and into hospital treatment than it was managing back in 2019.
“That’s one reason why waiting lists have risen to levels 60%, or 2.6 million, above where they were prior to the pandemic,” said Ben Zaranko, a research economist at the Institute for Fiscal Studies.
The NHS’s struggle to increase the number of planned operations it carries out means the waiting list will peak at about 8 million and will not start falling until late 2023, even though fewer people than expected have joined the list, the thinktank estimated in an analysis.
However, Matthew Taylor, the chief executive of the NHS Confederation, which represents care providers, said hospital bosses were “working flat out to tackle the backlog”. He highlighted the 132,000 staff vacancies across the health service and non-arrival so far of £500m ministers have pledged to boost social care, designed to cut the number of “delayed discharge” patients before winter.