NHS foundation trusts tackle rising patient demand

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NHS foundation trusts are working hard to provide patients with quality care in the face of sustained operational and financial pressures, according to Monitor.

Analysis by the health sector regulator shows that foundation trusts saw 2.7 million people in their A&E units between October and December 2014, 8% higher than the same period last year.

Subsequently, hospitals admitted 570,000 for further treatment, which is an extra 40,000 patients compared to last year. In addition, foundation trusts treated over 2.3 million non-emergency patients in the quarter, an increase of 7% over the same period last year.

However, this increased activity, combined with the continued need to make cost savings and use expensive agency staff, is putting trusts under exceptional pressure.

For example, ambulance foundation trusts dealt with 933,000 calls, a 13% increase compared to the same period last year, but some have staff vacancy rates of up to 24%. The 149 foundation trusts (which make up nearly two-thirds of all NHS trusts) have failed to meet national waiting times targets for A&E, routine and cancer care for 3 successive quarters.

Dr David Bennett, Chief Executive at Monitor, said:

Trusts are working harder than ever to overcome the challenges they face while still meeting patients’ expectations for quality care. However, the NHS needs to move rapidly towards more joined-up, efficient models of care if it is to deal with this continuing growth in demand for services.

A report to Monitor’s board on the performance of the foundation trust sector over the 9 months ended 31 December 2014 found:

The sector reported a deficit of £321m which was 5 times more than planned; 78 FTs (53%) were in deficit, of which 60 were acute trusts
The sector as a whole failed the A&E waiting time target of seeing 95% patients within 4 hours for the calendar year 2014
Trusts met some cancer waiting times targets for 62 day screening services, 31 first days treatment and 2-week referrals
42,600 people – an increase of 134% – waited on a trolley for more than 4 hours between the decision to admit them to A&E and their arrival on a ward, due to reduced bed availability between October and December 2014
There was an 8% increase (158,000 to 171,000) in the number of journeys made by foundation trust ambulance services
Trusts had a combined waiting list of 1.65 million, which was 40,000 less than between July and September 2014, but still 2.5% higher than last year
Trusts spent £419 million more on staff than planned because of high use of contract and agency staff
Trusts made £810 million worth of cost savings which is £210 million less than planned
Monitor took regulatory action against 28 trusts (19% of the sector) because of governance or financial concerns