NHS foundation trusts are under ‘sustained and exceptional pressure’ as they treat more urgently ill people than ever before, says health sector regulator Monitor.
The new figures reveal that foundation trusts treated a record-breaking 10.7 million emergency inpatients between April 2014 and March 2015 – a 574,000 increase on the previous year.
In addition, there was also a significant increase in non-emergency patients.
This increase in demand, combined with an ‘over-reliance’ on expensive agency staff and the need to make cost savings, is putting trusts under sustained and exceptional pressure, said Monitor.
This has meant that, overall, the 152 foundation trusts (the majority of NHS trusts) missed a number of national waiting times targets for A&E, routine operations and some cancer treatments for the entire year.
Financial pressures upon services also meant that the sector ended 2014/15 with a deficit of £349m for the first time, compared with a £10m planned deficit.
Worryingly, foundation trusts have warned Monitor that they are likely to be under even more strain in 2015/16.
Monitor’s chief executive, Dr David Bennett, said: ‘The last financial year was exceptionally challenging for the foundation trust sector, and it is clear the current one is following the same pattern. The sector can no longer afford to operate on a business-as-usual basis, and we all need to redouble our efforts to deliver substantial efficiency gains in order to ensure patients get the services they need.’
Dr Bennett stressed that this would doubtless involve some ‘significant changes’ to the way people work at some institutions.
Monitor is advising foundation trusts to reduce their over-reliance on agency staff in the long-term by improving their planning and building up their reserve staffing resources in a bid to protect their finances.
BMA council chair Dr Mark Porter said that Monitor’s figures revealed that NHS trusts in England reported a total deficit of £822m in 2014-15, compared with £115m the previous year.
‘These figures are extremely worrying and show the extent of the dire financial pressure many hospitals are under,’ said Dr Porter. ‘Successive governments have fragmented the NHS in England, valuing penny pinching and individual parts of the NHS running a surplus, over the delivery of effective, properly funded, joined-up care.’
Dr Porter said that the prices paid to hospitals for work done are being cut year on year to drive ‘efficiency savings’, but the effect is that hospitals are being pushed into deficit.
‘This is no way to run a health service that needs to meet rising demand from an ageing population with complex care needs and we call on Government to move away from the current approach to one of investment in health.’
Foundation trusts in trouble
- 77 foundation trusts (51%) ended 2014/15 in deficit – 70% were acute trusts
- Trusts spent £1.8bn on contract and agency staff, which is more than double the amount they had planned (£766m)
- Trusts made £1.17bn worth of cost savings compared with £1.23bn in 2013/14
- The foundation trust sector as a whole has missed the A&E waiting time target of seeing 95% patients within four hours since autumn 2013/14
- The size of the waiting list for routine operations reached 1.76 million, an 8.3% increase on 2013/14
- Between January and March 2015, 55,400 people waited on a trolley for more than four hours between the decision to admit them to A&E and their arrival on a ward, due to reduced bed availability
- Monitor intervened or agreed regulatory action at 32 trusts (21% of the sector) because of operational or financial concerns