Things are harder for the NHS now than during the pandemic, the head of the health service in England has said, as she warned of difficult months and years ahead.
Amanda Pritchard told a conference of health leaders it was difficult “not to be realistic about some of the challenges” the NHS faces both locally and nationally.
“When I started this job, I think I said at the time I thought that the pandemic would be the hardest thing any of us ever had to do,” she said.
“Over the last year, I’ve become really clear and I’ve said a number of times: it’s where we are now. It’s the months and years ahead that will bring the most complex challenges.
“And that isn’t to take anything away, by the way, from just how tough particularly some of that early period of the pandemic was.
“But (it’s) definitely proving to be the case, I think it is harder now. Why? Because, partly, we no longer have a single unifying mission.
“Instead, we are dealing with paradoxes, we’re dealing with complexity and we are dealing with uncertainty.”
The NHS England chief executive told the King’s Fund annual conference in central London she did not think patients always got the care they deserved.
“It’s the question that’s most likely to keep you up at night, it’s most likely to motivate you in the morning.
“Are our patients getting the standard of care they deserve? We know we can’t always answer yes to that question. We know we’ve got a job to do….”
Ms Pritchard said that among her concerns were standards of maternity care and services caring for vulnerable people with learning disabilities.
She said: “We know we’ve got a job to do, particularly on maternity services, but not just that, inpatient services for people living with learning disabilities with autism or with severe mental illness.”
NHS England is currently in discussion with the Government about future funding for the health service.
Ms Pritchard told the conference the NHS had already found efficiency savings worth billions of pounds. However, there is still a gap of around £7 billion.
She said: “Some of the challenges, stepping up to rising inflation are well-rehearsed in our national discussion.
“Where we are at the moment is being really clear that nobody is stepping back from the commitments that have been made. So the last spending review, the NHS committed to roughly twice the level… of efficiency than we’ve been asked to do previously.
“So that’s £12 billion over a three-year period.
“Due to some other pressures that we’ve absorbed this year that means we’re actually on track right now for £5.6 billion in year.”
She said it was right that the NHS continued to challenge itself on efficiency savings, but there is a job to do on working through the implications of inflation.
She added: “That is something that we’re in conversation with Government about at the moment – they are aware that NHS budgets will only stretch so far.”
On what the NHS provides for taxpayers’ money, Ms Pritchard said a million appointments per day are held in primary care, which is “significantly more” than before the pandemic.
She said the NHS was also tackling “those inevitable Covid backlogs”, saying the process was “difficult” but the health service was on track and had “fully recovered” on cancer referrals.
Earlier, Ms Pritchard said of efficiency savings: “We should also be realistic that in the grand scheme of the NHS budget, these savings can only be a margin of a margin and on their own they can’t ever be the whole answer.”