Our report shows that providers coped well with the extra pressures and halted the year-on-year decline in A&E performance seen during the same period over the previous four years.
Performance of the NHS provider sector for the month ended 31 December 2017.
What our findings tell us
Better operational planning ahead of winter
Performance against the four-hour A&E standard was 89.5% at the end of December, similar to performance for the same period last year which was 89.6%. This is testament to better operational planning ahead of winter by the NHS and to the hard work of NHS staff.
A rising demand in bed occupancy
Rising demand and high levels of bed occupancy have affected providers’ ability to admit patients who require planned care. Bed occupancy has been affected by delays in transfers of care to other settings, including social care. During Q3 there were around 470,000 bed days across acute, community and mental health providers occupied by delayed discharge patients (accounting for 4.6% of all beds).
Agency costs continue to decrease
Agency costs have continued to decrease significantly and despite an increase in bank staff – to cope with increased demand and vacancies – the sector spent £108 million less than planned on agency staff and £441 million less than the same period last year, a fall of 20%.
Slight reduction in vacancies
Included in the report for the first time is workforce data from providers, which shows that they employ 1.1 million whole time equivalent staff but that they have 100,000 vacancies. Vacancies have reduced slightly over the last quarter, but the high vacancy rates continue to have an impact on performance.
The provider deficit stood at £2.47 billion in 2015-16 and has been reduced through a series of measures including cutting down on expensive agency staff, efficiency measures and smarter procurement.
‘‘NHS staff have yet again delivered their best for patients in the face of rising demand. More people than ever before are going to emergency departments up and down the country at a time when providers are already having to tighten their belts. I would like to say my heartfelt thanks to NHS staff for their continued hard work and recognise that there is more hard work ahead.
‘Some providers appear to have managed the financial pressures better than others. We are working closely with those providers whose financial position has deteriorated seriously to ensure that they grip their problems while delivering the best possible care for their patients.
‘It would be unrealistic to assume the demand which has been building for a number of years is going to reverse. Local health systems need to work together to plan for capacity in future years that can meet the increasing levels of demand that we will continue to see.’
Ian Dalton, Chief Executive of NHS Improvement