In a speech to senior health officials, NHS England Managing Director Amanda Pritchard acknowledged that the cuts to the number of beds were too much. However, he blamed the difficulties on social care because hospitals could not accept the growing number of critically ill patients in need of emergency care and patients trapped in the back of ambulances outside A&E units. However, Health Minister Sajid Javid warned that there would be “no immediate cure” for the growing number of acute problems facing the NHS’s emergency services. And it made it clear that the service would have to face its many challenges without any new cash push. “Honestly, the situation we are currently seeing in emergency departments and ambulance services is as difficult as it is every winter before the pandemic,” Pritchard told delegates at the NHS ConfedExpo conference in Liverpool. While the growing need for care is a major cause of pressure in the NHS, “demand is not the whole story”. However, he pointed out the inadequacy of social care as the main reason why hospitals have so many patients who can not be discharged, despite being medically able to leave, and therefore why so many patients have to wait so long for to get a bed. “You can find the line from late departures, to A&E congestion, to slower ambulance response times,” Pritchard said. The NHS has for many years had fewer hospital beds than comparable countries, which in some ways shows how effective it is, he added. But hospital struggles show that “we have reached the point where this effectiveness actually becomes ineffective.” The agency has already set up 53 “virtual wards” – in which patients are treated at home to vacate hospital beds – but these initiatives alone are not enough, he added. Last month, Mark Docherty, director of nursing at the West Midlands Ambulance Service, said patients were “dying every day” because so many ambulances were stranded outside hospitals. Serious patient safety incidents caused by delays have quadrupled in the past year, he added. In a scathing message to delegates, Javid told them to make better use of the NHS funding record, not to expect any increase, and instead to modernize how it works. “The answer to all the challenges we face in the health sector can not always be more money. I think it is important to improve productivity. “I do not want my children, no one’s children, to grow up in a country where more than half of public spending is covered by health care at the expense of everything from education to housing.” Subscribe to the First Edition, our free daily newsletter – every morning at 7 p.m. BST Urging the NHS to make major reforms, he said: “It is possible to love the NHS and still demand change.” The service must “reduce demand through prevention, early detection and more effective care” and “improved use of funds, skills, management, data and innovative care models”. Prior to the conference, Matthew Taylor, chief executive of the NHS Confederation, had blamed the service for failing to meet the 12-year waiting period for underfunding care since the Conservatives came to power in 2010 and Javid for “manager batteries”. “When you have been in government for 12 years, recognizing the scale of the problems that exist now, problems that clearly reflect the decisions that have been made in those 12 years, is difficult to do politically,” said Taylor, a former No. 10 politician under Tony Blair.
