NHS funding crisis affecting community services - report

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Corridor before the hospital morgue

Financial pressures on the health service are affecting community services, such as testing for sexually transmitted diseases and district nursing, according to a new report by The King’s Fund health think tank.

The report, Understanding NHS financial pressures, found that, while public attention focuses on high-profile examples of rationing, such as restricting access to some types of treatment, other important services are suffering too.

The report follows publication of figures from NHS England showing a worst-ever performance against A&E and cancer treatment waiting times targets in January, as hospitals struggled to cope with demand over winter.

In the report, the King's Fund looked in detail at four services – testing and treatment for sexually transmitted infections (STIs), district nursing, elective hip replacement, and neonatal care.

It found some local authorities cut spending on STI testing and treatment by 20% between 2013/14 and 2015/16, with further cuts planned.

There are fewer clinics and reductions in staff in some areas, potentially putting patients and the general population at greater risk of infection.

In district nursing, staff are stretched, leading to high levels of stress and lower quality of care, while waiting times for hip replacements have increased and more patients are waiting longer than 18 weeks for treatment.

While neonatal care has not deteriorated, the financial pressures have done nothing to help longstanding challenges in some units, such as staff shortages, which can lead to babies being transferred a long way from their families.

Responding to the report, the NHS Confederation, representing hospitals and other NHS organisations, said the report highlights the difficulties faced by its members as they attempt to transform services.

Regional NHS organisations have clubbed together to draw up sustainability and transformation plans (STPs) in an attempt to make services more efficient, with a focus on preventive care.

While the chancellor Philip Hammond pledged and extra £425 million to help these over the next three years in his budget last week, the NHS Confederation says more is required.

NHS Confederation's chief executive, Niall Dixon, said: “New money for STPs announced in the budget is welcome, but no one should underestimate the size of the challenge - the NHS and local government need to find new ways of working together, which embrace prevention and help keep people healthy.”