1/11 Some quick thoughts on Q2 performance data just released by @NHSImprovement: improvement.nhs.uk/resources/quar…. Top line is trusts working absolutely flat out but failing to keep pace with unholy combination of rapidly rising demand, ongoing financial squeeze and workforce shortages.
2/11 Q2: demand for care continues inexorable rise. EG 4.3% year on year rise for A&E attendances & an eye watering 5.9% rise in emergency admissions. Way way ahead of planning guidance. All evidence shows similar demand growth in mental health, ambulance and community services.
3/11 Q2: trusts working flat out to cope with extra demand: for example, they admitted 1,000 more patients a day and treated 2,000 more A&E patients within four hours compared to same quarter last year. So record extra demand being met by record extra performance stretch....
4/11 Q2: stats like record number of patients treated nails lie being peddled by some that “trust sector is underperforming”. Reality is that trusts are working flat out but they simply can’t keep up with rising demand given current workforce, financial and capacity constraints.
5/11 Q2: @NHSImprovement report shows trusts doing well on finance at Q2 - current forecast outturn reduced from -£558m to -£439m. But we know PSF incentivises / “forces” trusts to be optimistic to get Q2 PSF share. We believe there is at least £500m of risk to this forecast.....
6/11 Q2: @paddyashdown moment coming up....In fact I will eat my hat if the 2018/19 end year provider deficit is less than -£900m. Most expert observers predicting that providers will do very well to match last year’s unaudited -£960m. Reasons for this include....
7/11 Q2: reasons for financial pressures include lower elective income; extra emergency care costs; higher costs to cover workforce shortages; CCGs under financial pressure unable/unwilling to buy more activity. So, yet again, providers will miss an unrealistic financial target.
8/11 Q2: @NHSImprovement right to argue we simply can’t go on like this - missing constitutional standards & financial targets; ever worsening performance; cycle of public failure..all despite trusts working flat out. Huge task but vital imperative to break out of this....
9/11 Q2 and long term plan: I get the importance of new commitments and NHS transformation. But a huge priority in the new long term plan must be to conclusively show how NHS frontline will recover performance and finances to where they should be. 2019/20 key first step.....
9/11 Q2 shows overwhelming importance of setting trusts a deliverable task in 2019/20 and properly funding the recovery reqiured. We have to show staff and public that NHS getting back to where we should be and that we won’t keep asking staff to do the impossible 365 days a year.
10/11 Q2, couple of details: trusts working flat out realising savings & forecasting record levels of savings again - £3.41 billion. But pressure evident - full year forecast £444m off recurrent savings planned & 62% greater reliance on non recurrents. #clearlynotsustainable
11/11 Q2 detail. No one likes a smart alec but...whilst there is welcome progress on reducing long stays it is impossible to see how we can hit original target, as we argued at the time when it was set. So we are going to be short of desired capacity for the coming winter.....
12/11 Q2. NHS performance is relatively predictable and follows a set pattern. All evidence in today’s Q2 report - e.g. size of rising demand, capacity overload, workforce shortages - suggests this winter is going to be very very difficult. Trusts will do their very best but...
13/11 Q2 - our formal public response here: nhsproviders.org/news-blogs/new…
