Unsustainable Pressures on Health & Social Care in England

Posted By Kirsty Dakin - 25th November 2021

The Guardian has reported that the Health and Social Care System in England is facing increased pressure, which is causing “unsustainable, untenable conditions”.

The Royal College of Nursing (RCN), is the world’s largest nursing union. It provides trade union support to nurses, midwives, student nurses, health care assistants and more.  An RCN report titled “10 Unsustainable Pressures on the Health and Care System in England” highlights the pressures currently faced in England on the services that are heavily reliant on nursing care. It was published in November 2021.

One of the main pressures discussed is the NHS bed occupancy rate. The report states that the bed occupancy rate currently exceeds 85%, the recommended level for safe acute care. The latest data “revealed that around two in five trusts exceeded the 85% bed occupancy rate between June and April 2021.” The RCN considers that this high rate is due to pressure from emergency admissions and delays in elective treatment as a result of the Covid-19 pandemic. The RCN states that the increase in emergency admissions are “likely to directly impact the ability of trusts to provide safe and timely services for all patients and can mean that a number of patients are not receiving the level of care they need.”

Another issue discussed is rising sickness absence in nurses across the NHS and social care. In June 2021, there were over 88,147 more sick days recorded, compared to June 2019, which is an increase of 22.3%.Of these sick days, 27,217 were taken due to mental health reasons such as anxiety, stress and depression. The RCN states that “this puts even more pressure on services and the ability of staff to deliver safe and effective care.”

There is also a high level of nursing vacancies. The latest statistics from June 2021 show that the number of (full-time equivalent) nursing vacancies is 38,952. The NHS published its central vacancy records in 2017, which show that this level has been consistent for a number of years and therefore illustrates the “serious and sustained pressure on professionals working in understaffed services.” The RCN states that “ensuring that registered nurse staffing levels in both the NHS and social care are sustainable must be a priority if the UK Government want to reduce delayed transfers of care and prevent avoidable acute admissions.”

The NHS is facing an increase in hospital waiting times. The RCN states that the pandemic led to a decrease in A&E attendances, however it is now back to its pre-pandemic levels. The report states that in October 2021, 7,059 patients were waiting for over 12 hours on “corridor trolley beds”, which is a “nine-fold increase compared to 725 in October 2019.” The report also states that in October 2021, the waiting times for an ambulances exceeded national targets in all categories. The RCN considers this to be “fundamentally unsafe and must not be normalised.”

There is a backlog in elective care and treatment. The report states that as of September 2021, the number of patients awaiting consultant-led elective treatment was5.8 million, which is the highest number since records began in August 2007. More than 300,000 people had been waiting more than 52 weeks to start treatment, which is 180 times the number in February 2020. The 2 week wait target for cancer patients to be seen by a consultant, which is expected in 93% of cases, is not being met; only 84.1% of patients referred in September 2021 were seen within 2 weeks. The report states that the Secretary of State has recognised this backlog and that “waiting times are likely to “get a lot worse” before they get better.”

There has been a decline in the number of registered nurses working in social care in England and this has been gradually reducing since 2012. The report states that “between 2021/13 and 2020/21 the number of jobs has fallen by 17,000.” The RCN attributes this to overall staff turnover and levels of sickness and that “staffing levels do not always enable and support staff to deliver safe and effective care for residents or people requiring specific care packages and support.”

There is insufficient domestic NHS and social care nursing supply. The RCN states that “the UK Government needs to substantially increase the supply of registered nurses to put the health and care system and the nursing profession on a sustainable footing.” There was a slow increase in registered nurses and midwives in March 2020 – March 2021, which is 11.4% slower than in 2019-2020. The report states that “the UK Government needs to take further action to recruit many more people into nursing higher education in England to address the thousands of nursing vacancies.”

One of the final pressures is the increased demand for social care services. The report states that “social care services have experiences years of underfunding, despite continued increasing population need.” The RCN states that “action needs to be taken to retain as many nursing staff as possible in light of serious staffing vacancies, as well as high levels of exhaustion and burnout.”

We are very concerned to read of the pressures on the nursing system and hope that the matters discussed in this report are taken seriously so that changes can be made.

If you believe that you or a loved one has been harmed due to delays in medical treatment, or you believe that a loved one has lost their life due to a delay in medical treatment, and you wish to speak to us about a potential claim, then please do not hesitate to call us on 0116 254 7456, for a no obligation discussion.