Health service faces ‘significant pressures’, NHS boss warns

The NHS is facing “really significant pressures”, the head of the health service has warned.

Amanda Pritchard, chief executive of the NHS in England, said the health service faces a “tough winter” and that she expects the NHS backlog to “get worse before it gets better”.

Caring for half a million Covid-19 patients in hospital as well as a surge in demand for urgent and emergency care have contributed to the pressures, she said.

Ms Pritchard also warned there are “thousands” of patients stuck in hospital because they are waiting for social care support – which she suggested may hamper tackling the record waiting list backlog.

Ms Pritchard told BBC Radio 4’s Today programme it would be “unfair” to ask staff to “continue to work at this same level of intensity forever”.

“NHS staff have worked absolutely tirelessly over the past 18 months as we’ve responded to the pandemic,” she said.

“We’ve seen now half a million people in hospital with Covid, and of course at the same time rolled out the fastest and largest vaccination programme in our history.

“But we are facing really significant pressures: We have ongoing pressures from Covid, yesterday there were 6,864 patients in hospital with Covid; we’ve seen demand rebound for urgent emergency care services – the most recent data that we published just last week tells that story very clearly – the highest-ever number of 999 calls in a month and over 1.4 million people treated in A&E departments; colleagues are giving really significant focus to recovering services affected by Covid – especially tackling backlogs; and we’re maintaining that vaccination programme.

“The other thing is the pressures on social care too and that has an impact on us – thousands of patients now in hospital who do need social care support to go home safely.”

Ms Pritchard said the NHS is “facing a really tough winter” and the “best thing” the public could do to help was take up their vaccination invitations and still come forward if they have any worrying symptoms.

She said that the waiting list – which now stands at a record 5.8 million – was expected to “get worse” before it gets better.

Trusts have been ordered to eliminate waits of more than two years by March next year.

Ms Pritchard said this would be a “difficult target” for some specialties.

She said “the other thing that is going to be difficult” is the level of people who need inpatient hospital care over the winter, adding: “The ability to get patients home safely to create empty beds for us to be able to admit more patients is also really important.”

Speaking later on Tuesday to the NHS Providers annual conference, Ms Pritchard said that “the road ahead ahead looks really difficult”.

And she said that the indications were that the pressure will “not let-up for a while”.

She said that the NHS knew the next few months would be “a winter like no other” adding: “so our collective focus therefore must be on patient safety”.

Ms Pritchard added that problems in the social care sector are causing “back door” problems in the NHS.

“Challenges at the back door – in discharging patients often to a very stretched social care system – are meaning patients are spending too long in A&E, meaning ambulances are spending too long waiting to handover patients, meaning response times are not what any of us want them to be.”

On workforce, she told the Today programme: “Nothing works without staff. We have seen our staff do the most amazing things over the last 18 months and they are under significant pressure. I think it is unfair to ask staff to continue to work at the same level of intensity forever.

“So, there’s a number of things we’ve got to do – we’ve got to support our staff now, recognising the pressure that they are under – we’ve done things nationally like roll out dozens of mental health hubs to support staff and we’ve got health and wellbeing offers nationally to complement those locally.

“We also need to continue to recruit more staff, international recruitment continues to play a role in that, and we’ve got a lot of nurses and doctors in training, in fact more this year than we’ve had before … but it is also looking to that longer term.

“That’s where we need to make sure that we’re working closely with Government and Health Education England on developing a long-term workforce plan.”

It comes amid warnings from NHS leaders that the service faces the “most difficult winter in its history”.

A report by NHS Providers, which represents NHS trusts in England, found the health service is facing unprecedented levels of pressure for this time of the year, which is impacted by issues in social care.

Chris Hopson, chief executive of the organisation, said: “The message from trust leaders is loud and clear: judging by the pressure the NHS is currently under, the service is heading for the most difficult winter in its history.”

NHS Providers urged the Government to offer cash bonuses of around £500 each to stop social care staff leaving the sector for Christmas jobs in hospitality, supermarkets or online firms such as Amazon.

Social care staff must now all be double-vaccinated to work in care homes, with those working in other settings having a deadline of April to get both jabs.

This has led to fears of a mass exodus in a sector that already has more than 100,000 vacancies.

Mr Hopson told the Today programme: “We’re going absolutely full pelt, but the problem is we’re seeing absolutely record levels of demand.

“Wherever you look, you’ve got NHS staff running absolutely full pelt when they’re very, very tired.

“But, actually, because we’ve got insufficient capacity, we can’t keep up.

“This is before we get into peak winter, which is usually January, so it is a time of concern but the NHS as always is doing everything we possibly can to provide the best quality of treatment to everybody who needs it.”