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Issues within the NHS - Coggle Diagram
Issues within the NHS
Insufficient Funding
- More than expected, but half the sum needed, the Autumn rise in NHS funding (£3.3bn) was well short of the £7bn sum that NHS England said was necessary to cope with inflation, energy and other costs for the period up and until 2024/25.
- “in real terms, core day-to-day spending on the NHS will rise by 2% a year by 2024/25, while capital spending will grow by just 0.2%”. This figure falls well short of the 3.6% average annual rises given to the NHS since its launch in 1948 according to a recent Health Foundation analysis.
- How much sustained funding is needed? Compelling evidence supports funding rises of 3-4% over the next decade. Back in 2018 the Institute of Financial Studies calculated that the NHS will need an extra 3.3% in funding a year for the next 15 years just to keep pace with cost pressures such as the rising numbers of older people and those living with chronic disease, but this figure takes no account extra costs from the pandemic or the impact of higher than expected prices.
- Funding to solve the workforce crisis is still missing from the NHS budget. The cost of the long awaited workforce strategy, which is expected in March 2023, but has been promised since 2017, will need to make realistic estimates of future staffing needs, and be backed by substantial extra funding.
- Also missing from NHS leaders’ current budgets is the money to resolve the current pay crisis, which will be crucial to tackling waiting lists and influential in retaining existing staff.
- Strong signs of financial pressure are already evident across the NHS, affecting decisions about what services can be afforded and raising the likelihood of cuts. Two thirds of the Integrated Care Services (local NHS commissioners) are already facing a £1.3bn deficits. Whilst hospital trusts are on course for a combined deficit of £2bn.
- The cost of delayed maintenance and repairs to England’s hospitals has rocketed from under £6bn in 2019 to £10.2bn in 2022, Half a dozen hospitals were built in the 1970s with defective concrete planks that are now a structural threat. Over the last decade capital cash strapped hospitals consistently reallocated capital funding to meet the day to day running costs in the NHS, the recent increase of 0.2% in real terms is therefore insufficient to meet the size of the backlog.
- How does NHS funding compare internationally? Average health spending in the UK between 2010 and 2019 was £3,005 per person – 18% below the EU14 average of £3,655. Matching the spending per head of France or Germany would have meant an extra £40bn and £73bn (21% to 39% increase respectively) available to spend on UK healthcare.
- New investment in prevention will help to control future health costs, however public health budgets have been cut by 24% on a real-terms per person basis since 2015/16. The NHS spends around 10% of its budget on treating diabetes – and 80% of that goes on the complications from the disease, In a Diabetes UK survey of 10,000 people with diabetes, “1 in 3 respondents had no contact with their diabetes healthcare team in 2021. Workforce shortages are a major driver of this disruption.”
- A long term plan to consistently to increase NHS funding over the next decade is crucial, to raise NHS capacity and provide more care. This is a key (but not the only) driver to improving access and standards. Only 10% of the public think the government has the right policies on the NHS – 82% believe funding should be increased and roughly the same percentage think the NHS should be funded primarily through taxation.
- The demand for healthcare services continues to rise, but the funding allocated to the NHS has not kept pace with this increasing demand.
- The lack of adequate funding puts a strain on resources, leading to longer waiting times, limited access to certain treatments, and difficulties in maintaining high-quality care. It also hampers the ability of the NHS to invest in new technologies and infrastructure improvements.
- This, in turn, leads to NHS doctor strikes across the country – which is a complicated issue with ethical implications that you need to know about in preparation for your Medicine interview.
Staff shortages
- England’s NHS does not have an adequate workforce strategy. Staffing shortages in health and adult social care are limiting the delivery of services.
- The NHS is grappling with significant staff shortages across various healthcare professions, including doctors, nurses, and allied health professionals.
- The shortage of healthcare professionals puts immense pressure on the existing workforce, leading to increased workloads, burnout, and compromised patient care. It also contributes to longer waiting times and reduced access to healthcare services.
- Addressing staff shortages requires long-term workforce planning, recruitment strategies, and investment in training and development programs.
The Backlog
- The COVID-19 pandemic has exacerbated an already existing backlog of patients awaiting treatment and procedures within the NHS. The backlog refers to the accumulation of patients who have experienced delays in receiving necessary care due to resource constraints and disruptions caused by the pandemic
- This backlog poses a significant challenge as it impacts patient outcomes, increases waiting times, and puts additional strain on healthcare providers. Clearing the backlog requires additional resources, increased capacity, and innovative approaches to manage patient flow effectively.
An ageing population
- Our population currently has more than three million people aged over 80 years old. By 2030, this figure is projected to almost double, and by 2050 reach eight million.
- Today one-in-six of the population is aged 65 and over, and by 2050 it will be one-in-four.
- An increasing number of people with long-term disability, chronic conditions and multiple health conditions will increase the need for care, and change the nature of the demand. This will put pressure on health and care systems to adapt to meet these changing demands.
- Without improvements in healthy life expectancy or in the productivity of the health service, the UK’s health and care costs will increase as the population ages. Interventions throughout a person’s lifetime, such as those promoting healthy living and decreasing social isolation, have significant potential to affect their health in old age.
- Demand for people to provide care for family and friends will increase. Supporting these carers, and addressing the health and employment outcomes associated with providing unpaid care, will be critical to ensuring this demand is met sustainably
- New and emerging technologies have the potential to change care in the home and community. Capitalising on the opportunity this offers will mean addressing barriers and being sensitive to public concerns around privacy.
- The UK’s population is ageing, which presents unique challenges for the NHS. An ageing population means a higher prevalence of chronic conditions and complex healthcare needs.
- This places increased demands on healthcare services, including long-term care, specialized geriatric services, and end-of-life care.
- The NHS must adapt to meet the specific needs of older adults, including integrated care models, enhanced community support, and improved coordination between healthcare and social care services.
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