Deterioration in NHS?

Services in the NHS in England are deteriorating in a way not seen since the early 1990s, a leading health think tank says.

A review by The King’s Fund says waiting times for A&E, cancer care and routine operations are worsening and deficits are growing. Such drops in performance had not been seen for 20 years.

But the think tank, which specialises in health care policy, said that, given the financial climate, the NHS had done as well as could be expected.

The King’s Fund chief economist, prof John Appleby, said: "The next government will inherit a health service that has run out of money and is operating at the very edge of its limits. There is now a real risk that patient care will deteriorate as service and financial pressures become overwhelming."

He said in terms of how standards were slipping - not how low they had reached - the situation was the worst it had been since the "early 1990s".

The review said that much of the deterioration had happened in the second-half of the last Parliament with many measures of performance being maintained in the first few years.

It added that the next government had to address the funding situation and would have to add the extra £8bn a year which NHS England says is needed by 2020. This was the "minimum" of what would be required.

The report - a review of performance during the last Parliament - highlights a range of problems as well as achievements.

These include: waiting time targets for A&E, hospital treatment and cancer care all being missed towards the end of the parliament, bed occupancy increasing to "very high levels" while delays in discharging patients had "risen significantly" and funding being increased by an average 0.8% a year.

The review also said that hospital infections, such as MRSA and Clostridium difficile, dropping to historically-low levels; public satisfaction reaching its second highest level ever, numbers of doctors and nurses increasing while management costs had been "significantly reduced" and levels of deficits increasing even though the NHS struggles to keep up with demand.

The review was the second part of the King's Fund pre-election study of the NHS during the five years of the coalition government.