Healthcare in the UK, Winter 2017
The Care Quality Commission has published its assessment of the current state of health and social care in the UK, identifying and clarifying trends that have been hitting the headlines over the past year.
Good quality care
On the basis of on-going inspections, the CQC reports that 'the majority of care that people receive is good' with evidence of improvement in those NHS Trusts where care had formerly been regarded as inadequate.
However, whilst widely regarded as safe and offering good quality, comprehensive care, it cannot be denied that the problems facing the NHS appear to be increasing.
Healthcare needs
The CQC report identifies the problems of increasing numbers of people with 'complex, chronic or multiple conditions' combined with the issues of an aging population as people live longer. This means that people need to be cared for over a longer period of time, with increasing health needs as they age, becoming more vulnerable to a variety of conditions.
This scenario creates a growing baseline level of demand on healthcare services nationwide.
A & E pressures
Alongside this development, the NHS has also been experiencing an increasing demand for Accident and Emergency services with over 20 million people attending A & E in 2016-2017. Where A & E attendees need to be hospitalised, this puts additional pressure on hospital provision which has been exceeding the recommended bed occupancy rate of 85% for the last 4 to 5 years.
GP Practices
Pressure on A & E services may partly be influenced by worsening levels of access to GP services. There have been frequent references this year to the numbers of GPs who are considering leaving the profession, the increasing number of surgeries which are closing and a reduction in the number of GPs being recruited.
A new private service has been launched this year, 'GP at Hand' offering consultations with GPs over the phone within two hours. The impact of this on traditional GP services and patient access to advice remains to be seen.
Bed shortages and social care
The non-availability of hospital beds has reached such an acute point this year that the NHS has started to consider the possibility of paying private individuals to house and care for patients who are ready to be discharged from hospital but are not well enough to care for themselves at home. Under normal circumstances, such people might be transferred to a care home until they can return to their own home but care and nursing home provision has been declining, compounding the problem.
Mental health services
Widespread concern has also been expressed this year regarding the state of mental health services, especially for the young where there is evidence that mental health problems are on the increase. Unfortunately, according to the CQC report, although there has been 'a steady rise in the number of people in contact with mental health services over the last few years...the number of psychiatric nurses has fallen by 12% in seven years'.
Funding
The head of the NHS has today been quoted in The Times as saying that the current health budget is £30 billion short of what is necessary.
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