Without more funding NHS ‘faces unpalatable decisions’ about jobs and levels of care

Hospitals will have to make “unpalatable” decisions about care levels and jobs unless the NHS gets an increase in funding, the head of one of the service’s largest trade bodies has warned.

NHS Providers chief executive Chris Hopson said the health service is “increasingly failing to do the job it wants to do, and the public needs it to do, through no fault of its own”.

Writing in The Observer, he warned that senior hospital trust managers face a “stark choice” between investing the money needed or “watching the NHS slowly deteriorate”.

He called for “an open, honest, realistic, national debate on what gives” if no more money is made available to health trusts in the Chancellor’s Autumn Statement on November 23.

He told the paper: “Thanks to the dedication of staff, NHS performance rarely goes off the edge of a cliff. As the 1990s showed, instead we get a long, slow decline that is only fully visible in retrospect. It’s therefore difficult to isolate a single point in that downward trajectory to sound a warning bell.

“But NHS trust bosses are now ringing that bell – we face a stark choice of investing the resources required to keep up with demand or watching the NHS slowly deteriorate.

“Trusts will, of course, do all they can to deliver efficiency savings and productivity improvements. But they are now saying it is impossible to provide the right quality of service and meet performance targets on the funding available.”

Mr Hopson’s intervention comes the day before senior NHS England directors face the Commons health select committee. Professor Keith Willett, director for acute care, and Pauline Philip, urgent and emergency care director, will join health minister Philip Dunne in being grilled by MPs.

It also sits against a background of junior doctors planning week-long walkouts in October, November and December in protest over a new contract.

Mr Hopson (pictured), whose organisation is the trade association for acute hospital, ambulance, community and mental health services in the NHS, suggested that if there is no more money available it could lead to rationing of care, shutting down some services, formally relaxing performance targets, increasing charges, and “more explicitly controlling the size of the NHS workforce”.

He added: “These are all approaches adopted by other public services such as prisons, local government and the police when faced with similar funding challenges over the past decade – though they would clearly provoke public unease and ministerial anxiety if applied to the NHS.”

A Department of Health spokesman told the newspaper: “We know the NHS is under pressure because of our ageing population, but we rightly expect the service to continue to ensure that patients get treated quickly.”

Chris Ham, chief executive of The King’s Fund charity, said: “The clear message from the NHS leaders, doctors and nurses I’ve spoken to over the last few weeks is that they are increasingly unable to cope with rising demand for services, maintain standards of care and stay within their budgets. Cuts in social care are adding to the pressures on the NHS and both health and social care have reached a critical point.

“The Government must be honest with the public about what the NHS can deliver with the funding it has been given. It is simply not realistic to expect hard pressed staff to deliver new commitments like seven day services while also meeting waiting time targets and reducing financial deficits.

“Social care is rapidly becoming a threadbare safety net for some of our poorest and most needy citizens. Without additional funding, delays in transferring patients from hospital to the community, already at record levels, will increase to the point where hospitals run out of beds. If the Prime Minister is serious about creating a more equal country that works for everyone, then tackling the crisis in social care must be an urgent priority.

“With winter approaching, the Government should heed the warning signs rather than wait for a full scale crisis to develop.”

_{Copyright (c) Press Association Ltd. 2016, All Rights Reserved. Picture (c) Jeff Overs / BBC / PA Wire.}