BMA analysis shows NHS England winter pressures extending right through summer

By agency reporter
April 2, 2018

The NHS can expect to see performance this summer as poor as that seen in recent winters, as so-called 'winter pressures' extend right through the year, according to new analysis from the British Medical Association.

The health service came under unprecedented pressure this winter, with A&E attendances, waiting times and admissions reaching alarming levels, and while summer would normally see the situation ease, the BMA says levels of demand and activity this summer will mirror winters of just two or three years ago. 

Using official data from the last five years, the BMA’s health policy team were able to forecast a number of scenarios for this summer’s NHS performance, measured in A&E attendances, waiting times, admissions and trolley waits.

The worst-case scenario would see the health service see a repeat of scenes experienced during winter 2016.

Best-case scenario for July, August, September 2018 (projected):

  • 5.89 million attendances at A&E
  • 613,000 people waiting over four hours at A&E
  • 89.6 per cent of patients seen, admitted or discharged within four hours
  • 1.51 million emergency admissions
  • 127,000 trolley waits of four or more hours
  • Comparable winter: 2015

Worst-case scenario for July, August, September 2018 (projected):

  • 6.2 million attendances at A&E
  • 774,000 people waiting over four hours at A&E
  • 87.5 per cent of patients seen, admitted or discharged within four hours
  • 1.57 million emergency admissions
  • 147,000 trolley waits of four or more hours
  • Comparable winter: 2016

Traditionally the summer offers a period of respite for the NHS. While attendances at A&E tend to increase, bed occupancy falls as emergency admissions go down. With more beds available, trusts can improve performance against the four-hour wait target and cut down on things like trolley waits.

However, in terms of performance and demand, the BMA’s analysis for this year paints a different picture.

The implications for trusts are that winter contingency plans continue to remain in place; for example, the University Hospitals of North Midlands NHS Trust is planning to keep its extra winter capacity open until the summer. 

As the process of dealing with the fallout of massive spikes in demand and pressures during the winter months now extends into summer, it begins to overlap with the early stages of planning for the following winter.

Dr Chaand Nagpaul, BMA council chair, said, “This data clearly shows what doctors working on the front line have been saying for some time – that the 'winter crisis' has truly been replaced by a year-round crisis.

“Doctors and patients have just endured one of the worst winters on record, resulting in thousands of cancelled operations, unacceptable long waits to be seen and people who are already at their most vulnerable having to face the indignity of being treated in hospital corridors. These scenes have become an all-too-familiar annual occurrence, each year stretching further into spring and appearing again earlier the next winter. We cannot accept that this is the new normal for the NHS.

“The government gave the health service £335 million in November to prepare for winter, but as we know, this proved a temporary sticking plaster that came too late in the day to avert another crisis. This research proves that this approach of cash top-ups and short-term fixes will no longer do. 

“The BMA estimates that health funding in England is more than £7 billion a year behind comparable European countries and this could rise to over £11 billion over the next three years.

“While we cautiously welcomed the prime minister’s commitment last week to a long-term funding plan for the NHS, this must be met with the reality of urgent and tangible new investment that will properly address the year-round pressures faced by the health service and ensure that patients receive safe, high-quality care.”

* More about NHS ressure points in England here

* British Medical Association https://www.bma.org.uk/

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