This week, the scale of the problems facing the NHS is becoming even clearer. A&E departments are struggling to meet demand, while nearly 40m patients wait longer than 14 days for a GP appointment. The pressures will continue to increase, as senior consultants are tempted into better-paying jobs abroad, and a Health Foundation report finds that an ageing population will lead to one in five people living with a chronic health condition by 2040.
The number of people in England living with a major chronic illness is likely to rise nine times faster than the healthy working age population, according to projections from the Health Foundation.
By 2040, the projections suggest, there will be 9.1 million people (one in five of the population) with a major health condition, a 37% increase from 2019. In contrast, the number of healthy working-age people will increase by just 4%.
The Health Foundation said this would have a major impact on the NHS, and would require a greater focus on care in the community than on hospitals.
Although most of the increase is the consequence of an ageing population, the report said, there will be a growing number of young people living in ill health too.
Fewer than half of patients attending A&E receive the help they need from doctors and nurses when they need it, the Care Quality Commission (CQC) has said.
A survey of more than 36,000 people using NHS urgent and emergency care in England last autumn found that only 45% were confident that they could “always” get help from clinical staff at any point during their stay, down from 58% two years previously.
The results also showed that waiting times have increased significantly for both A&E and urgent care centres, with 32% of people in A&E waiting more than an hour to speak to a doctor or nurse, compared with 15% in 2020, and 18% in 2016.
The proportion who said they had waited longer than four hours to be examined in A&E in 2022 was 17% – up from 4% in 2020 and 5% in 2018.
More than 38m patients in England have waited longer than a fortnight for a GP appointment since the government promised everyone would be able to have one within 14 days.
In September 2022, the government said that patients would be able to see a family doctor within two weeks of booking a consultation. Thérèse Coffey, the then health secretary, said the issue would be prioritised with a “laser-like focus”.
Since then, however, 38m appointments have taken place more than two weeks after they were requested, according to a House of Commons library analysis of NHS data.
Between October 2022 and May this year, nearly five million patients waited more than a fortnight for a GP appointment every month.
A number of senior doctors are leaving the NHS to work in other countries where they can double their salary and enjoy better working conditions.
The most popular countries include Ireland, Australia and the United Arab Emirates.
The problem of junior doctors leaving the NHS to work abroad is well-documented – junior doctors, who are younger, tend to have fewer commitments, and so find it easier to move. The phenomenon of senior doctors leaving, however, is relatively new. Simon Walsh, the deputy chair of the British Medical Association consultants’ committee, said rising numbers were tempted to take jobs abroad.
Global medical recruiters are even targeting picket lines. At the Queen Elizabeth hospital in Birmingham this week, a recruitment agency handed out bottled water to striking consultants and offered them new roles in Ireland paying up to £233,000.
Rishi Sunak, the prime minister, has told the Infected Blood Inquiry that the government will wait for the inquiry to complete its work before making decisions about compensation to the families affected.
In answer to a question from the Infected Blood Inquiry counsel, Jenni Richards KC, about compensation plans, Sunak said: “In order for the government to make decisions on compensation, it rightly has asked an independent inquiry to conclude its work to provide the advice to government and recommendations about what to do.”
He added that it was “very hard for me to second guess the decisions that were made by people in good faith to establish an independent, thorough investigation of all these issues.”
The Infected Blood Inquiry was established in 2017 to examine how thousands of patients in the UK developed HIV and hepatitis C through contaminated blood products given in the 1970s and 1980s. About 2,900 people died as a result.
A target set by NHS England that all trusts should have an electronic patient record (EPR) by March 2025 has been declared “unachievable” by the government’s Infrastructure and Projects Authority (IPA).
The digitisation programme was launched by NHS England and the government in 2021 to help all trusts reach a minimum level of digital capability. The aim was that 90% of all trusts should have an EPR of an acceptable standard by the end of 2023, and 100% by March 2025.
The report by the IPA, a government body for scrutinising major projects, says that “a number of NHS trusts are reporting they are unlikely to be able to fully implement an electronic patient record by March 2025.” It also reveals that the budget for the programme was cut by £700m at the beginning of last year from £2.6bn to £1.9bn. This was “to support other NHS England priorities”, the report says.