A resilient NHS cannot be built on "stop gap" measures and "patching" it up, a health leader has warned ahead of Thursday's autumn statement. Saffron Cordery, NHS Providers chief executive, told delegates at its annual conference in Liverpool she was pleading with politicians to "inject some long termism into your thinking" and to not take money away from areas such as equipment and maintaining buildings.
Next year, the NHS budget will rise to more than £157bn, but NHS England believes it will still be short of around £7bn. Ms Cordery said resilience will be significantly undermined, if on Thursday, "the Chancellor and the Health Secretary agree that it's acceptable to balance the NHS books by, yet again, raiding the hard-won capital budget". The capital budget is used for research and development and long-term investments in building and maintaining NHS land, facilities and equipment such as MRI or CT scanners.
Ms Cordery said: "After all, what is efficient about the mental health trust which has to spend hundreds of thousands every year in repairs to keep an outdated building going? What is efficient about the backlog maintenance bill having reached £10 billion rendering buildings unsafe or unusable, putting operating theatres out of action and forcing patients to be treated in substandard conditions? And finally, what is efficient about not investing in the means to digitise the NHS frontline?"
She urged ministers to take a longer-term view of the NHS, adding: "A truly resilient NHS will not be built by short term decisions, the kind that take us from now to the next general election. Patching, propping and stop gap measures are not lasting solutions. Resilient systems are led by the evidence. That evidence tells us that the NHS is an investable proposition."
It comes as a new NHS Providers report found fewer than half of NHS trusts will meet key recovery targets on waiting lists and cancer as services buckle under pressure. A poll of health trust leaders found nearly half (46%) strongly agreed or agreed they were on track to meet elective recovery and cancer targets by the end of the financial year.
A further 27% neither agreed or disagreed, while a quarter (24%) disagreed or strongly disagreed they could hit the targets, which were put in place after the pandemic. It comes as NHS waiting lists for treatment in England continue to reach record levels, with 7.1 million people on the overall waiting list and a raft of cancer targets routinely missed.
In February, NHS England said the number of people waiting more than 62 days from an urgent cancer referral to starting treatment should go back to pre-pandemic levels by March 2023. At present, just 61.7% of people (the average for 2022/23 so far) get cancer treatment within 62 days, compared with 77.2% before the pandemic.
NHS England also set a goal to deliver around 30% more planned treatments by 2024/25 than before the pandemic, with over 10% more in 2022/23 alone. However, the NHS is currently only hitting 96% of pre-pandemic levels in this area (this is the average figure for the first six months of this financial year).
The monthly average for 2019/20 was 1.36 million treatments started, and for 2022/23 so far it is 1.31 million. The health service has also been told to eliminate waits of over 18 months by April 2023, a target where there has been good progress.
The new NHS Providers report found trust leaders were more worried about this winter than any previous one, with nurse strikes and too few staff adding to the pressure. Some 85% of trust leaders agreed or strongly agreed they were more concerned about this winter than any previous one during their career, while only 6% disagreed.
