A growing cash crisis in the NHS could see routine knee and hip operations rationed going forward.
As the National Health Service in England struggles to make ends meet, other so-called “non-urgent” procedures could also be delayed. Patients waiting for cataract surgery and hernia operations could find themselves shunted down the list as health service funds dry up.
Prior to the Chancellor of the Exchequer’s Autumn Budget, which was presented to Parliament on 22 November 2017, NHS England chief executive Simon Stevens had requested a £4 billion funding boost to stop the health service going into meltdown.
However, Stevens was granted £2.8 billion instead, comprising £355 million this year to avert a winter crisis, £1.6 billion in 2018/19 and £900 million the year after.
Stevens told a board meeting that there was a limit to what could be done with the funds available.
NHS England’s priorities are to provide world-class cancer, mental health and primary (GP) care services. These are all areas it intends to “protect”.
As a result, other services will inevitably face longer delays or may not be provided at all in the future, unless more cash is found.
According to a report in The Times, Stevens effectively ripped up waiting-time targets for routine surgery. In addition, patients were told to stop expecting the NHS to treat coughs, indigestion and other minor conditions. In fact, GPs are now encouraged to send patients away without prescriptions for medicines they could buy over the counter.
Promising to make taxpayers’ money go further, Stevens outlined a list of 36 conditions that do not need to be treated on the NHS, including sore throats, acne and dandruff. This step alone is expected to save the health service £190 million.
Figures show that the number of people on waiting lists for orthopaedic referrals – the majority of which are hip and knee operations – has risen sharply from 376,000 in 2008 to 505,957 last year. Over 60,000 were not treated within the 18-week target limit. In fact, the goal of treating 92% of patients awaiting non-urgent surgery within 18 weeks has not been hit for over a year.
In another blow for patients, Stevens said new guidance issued by the National Institute for Health and Care Excellence (NICE) could not be implemented in 2018 unless funding was agreed in advance. It’s a decision that threatens best-practice advice due to be implemented next year for conditions from sight and hearing loss to arthritis and dementia care.
Three health think tanks – the Health Foundation, The King’s Fund and the Nuffield Trust – have warned that 2018 will be a “crunch year” for the NHS, with funding growth slowing to 0.4% – one of the lowest rates in the health service’s history.
Speaking about the situation facing the NHS, Chris Ham, chief executive of The King’s Fund, said: “After seven years of austerity, the dramatic improvements made in health care over the last 20 years are at risk of slipping away. The message is clear – unless the government finds the money the NHS and social care need, patients, service-users and their families will suffer the consequences.”
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