QMR 21 | November 2016

NHS faces difficult winter as demand for care increases

Big rises in demand for health care mean the NHS is heading into winter with its finances under pressure and performance against key indicators worsening.

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In this issue . . .

  • Financial pressures continue

    An increasing number of NHS organisations are concerned about meeting finance and efficiency targets.


    Nearly a third of trusts do not expect to hit their control totals.

    The number of NHS providers expecting to miss their control totals – financial targets set for each organisation – has increased from 13 per cent last quarter to nearly a third this time. With more than half of trusts also concerned about whether they will be able to meet efficiency targets, there is a risk that provider deficits may worsen as the year goes on.

    The plan is for provider deficits to be offset by a 1 per cent risk reserve held back from CCG budgets. However, 20 per cent of CCGs are relying on their reserve being released to meet financial targets, suggesting that not all of this money will be available to offset provider overspends.


    of CCGs are concerned about meeting their efficiency targets.

  • NHS performance deteriorates as demand increases

    Performance against waiting time targets and other key performance measures continued to deteriorate during the last quarter as the NHS faced increasing demand for services.


    more patients attended A&E departments than in the same quarter last year.

    The proportion of patients waiting longer than 18 weeks to begin hospital treatment increased to 9.4 per cent in September 2016, the worst performance since this target was introduced in April 2012.


    more bed days lost due to delays in discharging patients from hospital.

    The number of patients ready to be discharged but delayed in hospital is at a record level and rising faster than ever before, underlining the impact of cuts in social care on the NHS.

    “The most pressing priority for next week’s Autumn Statement is to provide more funding for social care.”

    Chris Ham, Chief Executive

  • General practice under pressure

    For the first time we are now monitoring general practice, and will be reporting on this every six months.

    “GPs must be supported to manage the increasing level of demand and the pressure this causes.”

    Emily Northern, GP trainee


    increase in patient contacts over past two years.

    Our new activity tracker shows a 9.9 per cent increase in the number of patient contacts over the two years up to quarter two 2016/17, confirming the huge pressures on general practice.


    increase in GP appointments for patients aged over 85.

    There has been an increase in the number of patient contacts among all age groups, but the rate of increase among patients aged 85 and over is more than twice as high as for any other age group.