Why is the NHS under so much pressure?

• An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care
• Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home
• Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice
• Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue

  Joyce Robins, from Patient Concern, said: “This is ridiculous; it’s extremely worrying and increasingly dangerous.”

  “We are seeing more and more managers filling in forms and less and less people actually doing the frontline work,” she said.

  Janet Davies, chief executive of the Royal College of Nursing said: “The drop in the number of nurses this year is deeply worrying, and particularly damaging when nurses are having to cope with rising numbers of patients.

  “The public will understandably question why the number of frontline staff is going down at the same time as the figure for managers is going up”.

  It came as health chiefs and the heads of social services wrote to Chancellor Philip Hammond, ahead of next months’ budget, urging him to increase spending by billions, and fully fund pay rises for NHS staff.  Under Government plans, NHS spending is due to increase by £8bn a year by 2020, compared with 2015. The NHS Confederation and Local Government Association said the cash boost should be brought forward, with an extra £5bn put in immediately, warning thervices were now “unable to keep up with demand”.The letter also suggests that around £30bn is needed within five years to cope with rising pressures.

  The NHS has been ordered to find £22bn savings by 2021, with 44 NHS “sustainability and transformation partnerships” created to embark on the work.

  But many of the arrangements have created dozens of new jobs, including communications executives and project management teams, with figures from around half of the bodies suggesting the creation of more than 150 jobs, with combined annual salaries of at least £8.5m.

  The new report shows the number of GPs fell by 2.3 per cent between September 2015 and June 2017, despite pledges to increase the number of family doctors by 5,000 by 2020.

  The NHS plans included targets to recruit 2,000 GPs from overseas.  But just 38 were recruited in the first six months of this year, the report shows.

  Meanwhile, the number of students starting undergraduate nursing degrees this year has dropped by 5.5 per cent in a year, with 1,220 fewer places taken up in England this autumn.

  Anita Charlesworth, director of research and economics at the Health Foundation, said: “There is a growing gap between rhetoric about the government’s ambitions to grow the NHS workforce, and the reality of falling numbers of nurses and GPs.”

  “This year has been characterised by a series of one-off announcements and initiatives, beset by unrealistic timescales and no overall strategy.

  “With winter approaching and staffing numbers in critical areas once again declining, the NHS will be relying on the efforts of its staff to meet the inevitable rising pressures. But in the long-term, both the people working for and the people using the NHS deserve better.’

  Jonathan Ashworth, shadow health secretary, said: “Theresa May has overseen an unprecedented workforce crisis in the NHS. This latest warning is the culmination of an incompetent strategy, which has left our health service with a shortage of 40,000 nurses, 3,500 midwives and 10,000 GPs.”

  “The public is under no illusions: a repeat of last winter is entirely intolerable. In next month’s Budget Theresa May must take urgent action to secure a sustainable workforce in our NHS in years to come.”

  A Department of Health spokesman said: “Patients can be assured that the NHS has the staff it needs to provide the best possible care – over 12,700 more doctors, 10,600 more nurses on our wards and over 5,600 fewer managers and senior managers since May 2010.”