Trusts say NHS must be honest with the public

A survey for NHS Providers showed that 91% of trust leaders believe public debate on the challenges and opportunities facing the NHS, together with its long-term future, has been inadequate.

Delving deeper into the current challenges, the survey found that only 29% of trust leaders believed their organisation had adequate staff numbers, with the right mix and quality to deliver the best possible care to patients and service users. They were also concerned about access to capital (72%), as well as funding for social care (90%) and public health (77%).

More than half of the respondents (55%) are chief executives, while 39% are trust chairs and 6% are in other roles. The report, The state of the NHS provider sector, said that only 35% thought their organisation’s financial performance would improve over the next 12 months – 23% forecast it would deteriorate and 42% said it would stay the same. Acute trust leaders were more likely to feel finances would improve – NHS Providers said it was likely this was because of changes in payment mechanisms and financial flows.

The recent announcements of capital funding were welcome, but the uplift still fell short of the amount needed to clear the £6bn maintenance backlog and invest for the future. The report said there were questions over how the additional capital would be allocated between 2021 and 2025. ‘It will be important to ensure that the extra funding for 2020-25 does translate into a £3bn increase to the current CDEL baseline over that time,’ it added.

It added that just 29% of leaders were confident that system working will move at the necessary pace to help them deliver the NHS long-term plan. And more than half said the support needed to join up hospital, GP and community services was not in place.

Chris Hopson (pictured), chief executive of NHS Providers, said: ‘It is very striking that over 90% of trust leaders are worried that there hasn’t been the full, frank and open national conversation about the severe pressures facing the NHS and how much these constrain what it can deliver.

‘It’s an uncomfortable debate to have. The government wants to be seen as an effective steward of the NHS. NHS England and Improvement want to be seen to lead the service effectively. And frontline leaders want to provide outstanding care to every patient. But we need greater realism about how much the NHS can deliver, and how quickly, given where we currently are and the challenges we face.’

The NHS was facing rising demand, workforce issues and had to recover from the longest funding squeeze in its history, he added. ‘Unless we level with the public about how long it will take to recover from where we are and how quickly we can deliver the NHS long term plan, public commitment to the NHS is on the line.’