NHS faces £1bn deficit and widespread shortages of staff

By Laura Donelly - The Daily Telegraph  21st February 2018


HS hospitals are facing a financial black hole almost twice as bad as was predicted, new figures show.

Experts said the updates made “grim reading” for the NHS, with trusts struggling to cope with widespread staff shortages and rising demand.

The quarterly report from NHS Improvement predicts that hospitals will reach a deficit of £930m by the end of this financial  year - £435m worse than planned.

Meanwhile, the NHS reported almost 100,000 vacancies, with thinktank the Nuffield Trust raising fears that the situation is set to “spiral out of control”.

One in eleven jobs is now vacant, with even higher rates of shortages among nurses, the figures show.

Watchdogs said NHS staff were doing their best in the face of rising demand.

NHS leaders said the health service was “pushed to the limit”.

Why is the NHS under so much pressure?

  • An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care

  • Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home

  • Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice

  • Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue


Saffron Cordery, NHS Providers’ director of policy and strategy, said: “Despite working at full stretch with around 100,000 vacancies and a real risk of staff burnout, and despite treating 6 per cent more emergency patients year on year in December, trusts cannot close the gap between what they are being asked to deliver and the funding available.”

NHS Improvement said that the deficit is still not as high as it was in 2015/16 when it stood at £2.47 billion, officials said that the deficit had been reduced through a series of measures including cutting down on expensive agency staff, efficiency measures and "smarter" procurement.

The regulator said that the majority of the financial decline against plan in the current year comes from a small number of trusts with larger than expected deficits.

The ten worst trusts for A&E waiting times in January


Percentage in 4 hours or less (type 1)

The Hillingdon Hospitals NHS Foundation Trust


Blackpool Teaching Hospitals NHS Foundation Trust


University Hospitals Of North Midlands NHS Trust


Royal Cornwall Hospitals NHS Trust


Shrewsbury And Telford Hospital NHS Trust


West Hertfordshire Hospitals NHS Trust


East Lancashire Hospitals NHS Trust


Worcestershire Acute Hospitals NHS Trust


Norfolk And Norwich University Hospitals NHS Foundation Trust


London North West Healthcare NHS Trust



[Target is 95% within 4 hours]     [my bold - London NW Healthcare NHS Trust includes Northwick Park and Ealing Hospitals]

Meanwhile it said that NHS providers had maintained A&E performance, with 89.5 per cent of patients being seen within four hours, a similar rate to last year.

NHS Improvement chief executive Ian Dalton said: "Some providers appear to have managed the financial pressures better than others.

"We are working closely with those providers whose financial position has deteriorated seriously to ensure that they grip their problems while delivering the best possible care for their patients."

A Department of Health and Social Care spokesman said: "Despite the challenging winter months, the NHS has cared for record numbers of patients and fewer NHS trusts are expected to be in deficit at the end of this financial year.

"Whilst the NHS was prioritised in the recent Budget with an extra £2.8billion for the next two years, NHS trusts must now tighten their grip on finances.

"There are currently record numbers of staff working in the NHS and the vast majority of vacancies are filled by bank and agency staff so patient care is not compromised. We are supporting staff to improve work/life balance by working more flexibly and have announced the biggest ever expansion of training places for both doctors and nurses."