Has the NHS Reached Tipping Point?

Tim Locke

November 11, 2021

Editor's note, 11 November 2021: This article was updated with additional comment.

The NHS is under such unsustainable pressure that it is at a "tipping point", the NHS Confederation has warned.

The comments follow a poll of health leaders with 88% saying the demands are unsustainable, and 87% saying staff shortages across the NHS are putting patient safety and care at risk.

Primary and emergency care were flagged as the areas of greatest concern.

The concerns were raised ahead of another set of record waiting list data for the NHS in England.

Plunging Into Crisis

"The Health and Social Care Secretary says the NHS is not under unsustainable pressure, but NHS leaders are clear that we have reached a tipping point," said the group's Chief Executive, Matthew Taylor.

"Front line providers across all parts of the NHS are under intolerable pressure and we know this is going to get worse over the winter unless we take action now.

"The Government must take every step possible to prevent the NHS from plunging into crisis."

He welcomed recent funding announcements in England, "but we cannot immediately buy our way out of this potential crisis, due to the 90,000 plus vacancies we are carrying in the NHS. That means it would be better to allocate more immediate funding from the recent funding settlement to social care services, as boosting the numbers of care staff will have much greater impact on reducing pressures on hospitals and other parts of the NHS."

Waiting Lists

Today's NHS performance data for England showed 5.8 million people were waiting to start treatment as of September, a new record.

Also, 369,207 were waiting longer than 6 weeks for key diagnostic tests.

The number of patients waiting longer than 2 years for treatment was 12,491.

Ambulance Waits

October was the busiest month on record for NHS 999 services and major A&E departments treated more than 1.4 million people in October, the third highest of all time.

Ahead of today's performance statistics, Richard Webber from the College of Paramedics told the BBC that ambulance handover waits were putting lives at risk: "It means on a 12-hour shift we can only attend two or three incidents, whereas previously we would do six, seven, or eight." Members "have never before experienced anything like this at this time of the year," he said.

Also commenting today, Dr Denise Langhor, emergency medicine lead at the BMA, and Dr Vishal Sharma, chair of the consultants committee, said: "It’s appalling that Government is standing by as data shows the NHS reporting consistently record-breaking numbers of people waiting for care and treatment in England. The Government has said that the NHS is under ‘sustainable pressure’ but these figures paint a very different picture – far closer to the truth. 
 
"Today’s data shows we have a health service that is nowhere near sustainable and there are multiple reasons for this. We’re already seeing elective care being cancelled again in some parts of the country, and ambulance services struggling to keep up with demand." 

The statement continued: "This winter is already set to threaten the recovery of our health service, but the longer Government waits to act, the less likely it’ll be that we even have an NHS to save."

Tim Gardner, Senior Fellow at the Health Foundation, said: "The Government has said that the NHS is under ‘sustainable pressure’, but it would be extraordinary to look at what’s happening in the NHS right now and claim that it is sustainable." 

Deborah Ward, senior analyst at The King’s Fund said: "Today’s stats reveal the worst performance since current records began for ambulance calls, A&Es, and waits for planned hospital care. In a normal year any one of these would ring alarm bells; taken together before winter has even begun they suggest a health and care system running hot for such a sustained period whilst still dealing with COVID-19, it is now on its knees."

COVID Cases Down

Latest data from the ZOE COVID Study suggest there's been the biggest weekly drop in COVID-19 cases so far this year.

The 18% drop means symptomatic coronavirus prevalence is now estimated to be on average:

  • 1 in 58 people across the UK

  • 1 in 57 in England

  • 1 in 47 in Wales

  • 1 in 84 in Scotland

The UK R number is now estimated to be around 0.9.

ZOE lead scientist, Professor Tim Spector, said in a statement: "This drop in cases is the largest weekly decline we’ve seen all year, and is being driven by a sustained fall in cases among children over the last 2 weeks. However, cases are still high and, worryingly, we’re still seeing high death rates as COVID takes up to 8% of hospital beds.

"As we head into the colder months, we’re seeing a lot of sickness in the population with widespread outbreaks of colds and still high levels of COVID. Knowing the difference between the two is harder than ever, as cases in the vaccinated are mild and include symptoms like sneezing, headache and a runny nose and can be easily transmitted to family members or work colleagues. To keep numbers down it’s crucial for everyone eligible to get their booster jabs, even if they have recently had a COVID infection, as we’ve shown natural infections do not always produce an immune response and protection. We know from our research that the vaccines (given in 3 doses) provide the greatest possible protection against contracting the virus, and being admitted to hospital with more serious symptoms."

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