There has been plenty of concern raised about the NHS over the past few years, with the latest headline warning that NHS England is treating too many patients as an emergency. Is it all bad for the organisation though? Join Tilly Bailey & Irvine Law Firm, experts in hospital negligence claims, as they weigh up both the positive and negative aspects of the NHS as we head further into 2018:
Warning about the NHS treating too many patients as an emergency
It was the National Audit Office (NAO) — Whitehall’s spending watchdog— which raised concerns in March that hospitals across England are currently admitting many people as medical emergencies. They pointed out that the country’s hospitals are collectively treating 5.8 million patients as emergency admissions on an annual basis, which is an increase of 24 per cent when compared to figures recorded a decade ago. They estimate that this costs the health service £13.7 billion; close to a 10th of its overall budget.
According to the watchdog, the knock-on effects of this are strain on the NHS’s finances and additional threats to the organisation’s ability to function.
The NAO’s report did deliver praise to NHS England by pointing out that it has been effective at handling the extra number of patients. However, it also criticised the organisation’s failure to establish enough services which operate outside of their hospitals with the aim of keeping patients healthy.
“[The health service] cannot know if its approach is achieving enduring results until it understands whether reported increases in readmissions are a sign that some people admitted as an emergency are being discharged too soon,” the watchdog outlined. “The NHS also still has too many avoidable admissions and too much unexplained variation. A lot of effort is being made and progress can be seen in some areas, but the challenge of managing emergency admissions is far from being under control.”
Organisations and health unions which make up the NHS were receptive of the conclusions made by the NAO in its report. Donna Kinnair, the director of nursing, policy and practice at the Royal College of Nursing, commented: “People, particularly older people, are not getting the support they need in the community, which leads to more emergency admissions and dangerous levels of bed occupancy when demand is high, as we have seen this winter.”
However, Professor Keith Willett, the medical director for acute care at NHS England, was also keen to note: “As the report states, there are 12 per cent fewer A&E patients being admitted than was predicted at the start of the decade, and hospitals, community trusts and GPs trialling new models of care have meaningfully reduced admissions compared with their peers. In addition, growth in the cost of managing emergency admissions has been less than a third of the growth in demand.”
Rise in violence against NHS staff
Another concern within the NHS at the moment is the increase in violence that has been recorded against the organisation’s workers.
According to data obtained from 181 of the 244 NHS hospital trusts by the Health Service Journal and trade union Unison following a Freedom of Information request, 56,435 attacks against staff were reported by the trusts in 2016/17. This is up from the 51,447 attacks which were recorded during the previous year. The pressure caused from funding cuts and staff shortages at the NHS were acknowledged as creating a “hostile atmosphere” for workers.
Sara Gorton, the head of health at Unison, commented: “It’s no accident that trusts where the pressures seem the most extreme — where there are huge financial deficits or where it’s a struggle to meet growing demands on services — have seen the steepest rise in the number of attacks. This desperate situation is only set to worsen as the squeeze on resources gets tighter.”
A spokesperson for NHS England has responded to the findings, by stating: “It is completely unacceptable that a nurse, paramedic, porter or any member of NHS staff should be assaulted physically or verbally as they care for patients. NHS England continues to work with trusts and any of our staff affected, to help the police and other authorities do everything needed when an assault takes place.”
Furthermore, a Department of Health and Social Care spokesperson stressed that they “are making crucial legal changes to ensure those who are violent face the full force of the law and NHS employers should have no hesitation in involving the police if their staff are subject to aggression or violence”.
Personalised NHS budgets could reduce pressures on the health system
Steps seem to be made to reduce the amount of pressure on the NHS. Government proposals revealed in April, for instance, could see up to 350,000 people with physical disabilities and mental health conditions across the country being giving the option to receive personal allowances for their own care needs.
Those eligible for the allowances will be given the right to select and pay for treatments that they either need or want at their own discretion. The money would either be delivered to them through a direct payment, given to a third-party to manage or left with the NHS to control.
Ministers are confident that the initiative has the potential to improve satisfaction ratings throughout the NHS, not to mention alleviating the pressure being placed on social care budgets. NHS head Simon Stevens backs the proposals, as does the country’s health secretary Jeremy Hunt. It could be in place as early as the end of 2018 when the government outlines its changes to the nation’s health and social care system.
Minister for care Caroline Dinenage noted: “These changes will put the power back into the hands of patients and their families, potentially allowing up to 350,000 extra people to take up a personal health budget if they so wish. This would not only improve quality of life and the care they receive, it will offer good value for money for the taxpayer and reduce pressure on emergency care by joining up health and social care services at a local level.”
New technology coming to the NHS
The pressure being felt on the NHS could be eased further with the introduction of new technology.
For instance, NHS England is reportedly fast-tracking the launch of four new pieces of technology which the organisation’s chief executive Simon Stevens has claimed “will improve patient safety and potentially reduce the need for invasive and expensive tests”.
The four pieces of technology which could soon be seen across NHS facilities in the months to come are as follows:
- Endocuff Vision — This is a new type of ‘bowel scope’ which aims to improve the colorectal examination of patients who need to undergo bowel cancer tests.
- HeartFlow — This is a new form of advanced image analysis software. When used, a 3D model of the coronary arteries is created. This model can then be used to analyse the impact that blockages can have on blood flow, allowing suspected coronary artery disease to be quickly diagnosed among patients.
- Plus Sutures — This is a new type of surgical suture known as stitching. By using antimicrobial suture packs, the rate of surgery-linked infections like MRSA can be reduced.
- SecurAcarth — This device works to secure catheters, so to reduce the risk of infection among patients who have a peripherally inserted central catheter. It is also claimed that the device will cut the time taken to treat and care for dressing changes.
Meanwhile in the North East of England, a number of academic and healthcare institutions have agreed to pool their resources as they aim to create their own advancements in the medical diagnostics field.
Deemed Diagnostics North East, the collaboration involves the Academic Health Science Network for the North East and North Cumbria, the Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. During the partnership, the institutes will look to develop new diagnostic tests and devices and aim to introduce them to patients in a more rapid manner.
Michael Wright, Newcastle Hospitals’ deputy medical director, commented: “Our strong collaboration, allied to first class clinical facilities and a strong culture of clinical research, is ideally placed to accelerate the pathway from innovation through to patient benefit.”
Time will tell whether schemes such as those detailed above will help to reduce the pressure that the NHS has been subjected to recently.
Sources: https://www.theguardian.com/society/2018/mar/02/nhs-england-too-many-patients-as-emergency-nao-warns https://www.independent.co.uk/news/health/nhs-staff-shortages-violence-physical-assault-mental-health-budget-cuts-unison-hsj-a8307476.html https://www.theguardian.com/society/2018/apr/17/rise-in-attacks-on-nhs-workers-blamed-on-lack-of-staff-money-and-delays https://www.theguardian.com/society/2018/apr/16/plans-to-extend-personalised-health-budget-scheme https://www.mirror.co.uk/money/hundreds-thousands-nhs-patients-given-12372318 https://www.digitalhealth.net/2018/04/nhs-england-four-innovations-fast-track/ https://www.digitalhealth.net/2018/04/new-partnership-diagnostic-technology/