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Is the NHS beyond breaking point? 

Nature

This article will discuss the current pressures facing the NHS. With the effects of COVID-19 expected to cause detrimental long-term effects to the NHS, with the growing backlog of 5.7 million waiting to start hospital treatment, staff shortages of 18,829 and only 68% of cancer consultancy appointments reaching the 62-day GP referral target, the NHS must be able to recover and treat patients within the expected target. This article will also discuss how your company can help reduce the burden on the NHS, through an e-Pharmacy partnership. 

How has COVID-19 increased the pressure on the NHS? 

Since January 2020, the NHS started to redirect their activity in response to COVID-19 [1]. Despite vaccine and lockdown efforts across the past two years, the NHS is still experiencing the effects of COVID-19 on its operations. The main issues the NHS appears to be currently facing in relation to COVID-19 are: Growing backlog; cancer consultancy appointments failing to reach crucial targets; increased waiting list times; staff shortages and increased A&E waiting times [2] The immense pressure of the NHS has meant most crucial targets have not been met. 

Growing Backlog

In 2020, the number of in-person appointments dropped significantly, which was a high concern as it was meant there were potentially delayed diagnoses, and long-term health conditions were not treated effectively. Although these figures recovered by September 2020, there is still major delay in patients being seen in target times. At the end of August 2021, there were 5.7 million waiting to start their routine hospital appointment [3]. Of the 5.7 million, 9,754 were waiting more than 2 years to begin treatment.

Cancer Consultancy targets missed

There is a target for 85% of cancer consultations to occur within the 62 days. However, due to the increasing backlog, only 68% have been seen within the 62 day target [4]. Estimations from NAO predict there have been approximately 240,000-740,000 missing urgent referrals for cancer since the start of the pandemic, and approximately 35,000 – 60,000 missing first treatments for cancer within the same periods.

Increased A&E waiting times

The current waiting target for patients to be seen in A&E is 4 hours. COVID-19 appears to have significantly disrupted this figure, where in October 2021, more than 30% of people admitted to hospital from A&E had to wait more than 4 hours for treatment [5].

Staff shortages

Due to the increasing COVID-19 infections, more NHS staff are absent from work due to infection or isolation. On December 19th 2021, the number of NHS staff absent at acute trusts across England reached 18,829 [6]. Unfortunately, this is an increasing figure, as it was up 54% from the week prior, and up 51% from the start of December. This places an increasing amount of pressure of NHS staff, where most are reportedly working 14 hour shifts to make up for the current shortages.

Is funding driving the NHS beyond breaking point?  

Nature

The Department of Health and Social Care has increased their core planned spending in England year-on-year since 2008 [7]. The figure shows this planned increase in budget: 

Alongside this, there is an NHS five-year funding deal which would see the NHS funding rise by £33.9 billion by 2024, which will focus on capital investment, public health and the education and training of current NHS staff. Although these figures appear to be positive steps in the right direction, further research indicates there is still not enough funding, and so parts of the health service are still struggling majorly. Two organisations representing the NHS have stated the Government needs to boost funding by an extra £10bn, or services like A&E, cancer care, and cardiac care will be put at risk [8]. Specifically, the extra funding will be needed to cover COVID-19 costs, and services have stated without extra funding, waiting lists could double and the current 5.7 million backlog could reach 13 million. This indicates the NHS needs more Government intervention to help relieve some of the pressure they are currently facing. 

What is happening to General Practices (GPs)? 

Research from Pulse shows that nearly 800 GP practices have closed over the past 8 years. The main reasons for these GP practice closures appear to be a lack of funding, intense workload pressures and a lack of GP staff [9]. During 2020, almost 100 GP practices closed due to these reasons, which has caused major knock-on-effects for millions of patients, which may lead to increased pressures at other local GPs, and also increase the backlog of patient care. In fact, recent figures highlighting GPs indicates there are only 0.45 fully qualified GPs per 1,000 patients, which is down 0.7 from 2015, where under resourcing and a lack of staff appear to be the main reasons for this [10]. 

What is the effect on prescriptions? 

Additionally, the number of consultations and prescriptions have increased significantly over the past year, with October 2021 seeing 1,088,438 more repeat prescriptions, as compared to October 2020. This indicates GPs are under increasing pressure, however due to the lack of GP services, this is having major knock-on-effects on patient care. Majorly, throughout the course of 2021, staff shortages have meant pharmacies are operating at a lower capacity, and therefore cannot meet the increase in demand for repeat prescriptions and medication. For example, in November 2021, a Pharmacy in Wrington experienced a major backlog of 2,000 prescriptions leaving some patients waiting almost 12 days for their medication [11], which is of high concern when many patients cannot access their medication. 

How can a partnership with e-Pharmacy reduce the burden on the NHS? 

e-Pharmacy is an API service which can be directly integrated into any existing website or mobile app, which allows customers to order prescription medication in a safe and regulated way, alongside the businesses existing products. With access to hundreds of treatments and medications, your customers will benefit from quick and affordable access to help treat their medical conditions. In turn, this will reduce the burden on the NHS as patients can order their repeat prescriptions and medication through e-Pharmacy, rather than going to GPs or to A&E for acute conditions. 

How will your business benefit from an e-Pharmacy partnership? 

Partners will benefit from a profitable commission, whilst e-Pharmacy will perform clinical safety checks, and manage end to end fulfilment. As well as this, partners will benefit from a further satisfied customer base, where e-Pharmacy works with numerous industries: 

References 

[1] NHS Digital | What we did in 2019-20: COVID-19 response | https://digital.nhs.uk/about-nhs-digital/corporate-information-and-documents/nhs-digital-s-annual-reports-and-accounts/nhs-digital-annual-report-and-accounts-2019-20/what-we-did-in-2019-20-covid-19-response  

[2] BMA | Pressure points in the NHS | https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressure-points-in-the-nhs  

[3] Sky News | NHS waiting lists: Backlog hits record high with nearly 6 million waiting treatment in England | https://news.sky.com/story/nhs-waiting-lists-backlog-hits-record-high-with-nearly-six-million-awaiting-treatment-in-england-12433516b  

[4] NAO | NHS backlogs & waiting times in England | https://www.nao.org.uk/wp-content/uploads/2021/07/NHS-backlogs-and-waiting-times-in-England.pdf  

[5] Sky News | Waiting times from A&E to hospital bed or treatment at their longest ever, NHS England data shows | https://news.sky.com/story/a-e-to-ward-bed-waiting-time-at-its-longest-ever-nhs-england-data-shows-12465871  

[6] The Independent | NHS staff ‘in despair’ amid mass staff shortages over Christmas | https://www.independent.co.uk/news/health/nhs-mass-staff-shortage-christmas-b1981961.html  

[7] KingsFund | The NHS budget and how it has changed | https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget  

[8] The Independent | NHS services will be cut without £10bn extra funding, government warned | https://www.independent.co.uk/news/uk/politics/nhs-services-cut-funding-johnson-b1913040.html  

[9] RCGP | Increase in GP practice closures highlights workload and workforce pressures facing general practice, says RCGP | https://www.rcgp.org.uk/about-us/news/2021/april/increase-in-gp-practice-closures-highlights-pressures.aspx  

[10] BMA | Pressures in general practice | https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice  

[11] SomersetLive | Patients left waiting 10 days for medication due to prescription backlog | https://www.somersetlive.co.uk/news/somerset-news/patients-left-waiting-10-days-6258690  

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