The quality of patient care has declined in many NHS organisations and the outlook is even more pessimistic according to managers who are struggling to meet financial targets for cutbacks and efficiencies.
A survey of 48 NHS finance managers by the Kings Fund found that a third reported the quality of care as having declined in their area during the past year, around double the number voicing such fears in the previous quarterly report.
At the end of the second year of the so-called ‘Nicholson Challenge’ to find £20bn in productivity improvements by 2015, most NHS organisations were reported to be on track to meet their own financial targets and only three out of 48 surveyed anticipated a deficit. However, two thirds of NHS finance managers were pessimistic about the general financial state of their local health economy over the next 12 months.
Most key NHS performance indicators remained stable, but the proportion of patients waiting more than four hours in A&E (4.3%) was at its highest level for this quarter since 2003/04. Waiting times for hospital treatment remained stable, as did rates of delay in transferring patients out of hospital, although more than 60% of NHS finance directors reported that delayed transfers of care had worsened over the last year.
There was improvement in rates of health care-acquired infection, with a 13.5% drop in C difficile and a drop of nearly 12% in MRSA year-on-year counts to November 2012.
The report showed there had been a reduction of 24,313 full-time NHS posts from March 2010 to October 2012, including 4,000 nurses, midwives and health visitors, and 8000 managers. However, the number of consultants has risen by 12.3% since 2009.