The King’s Fund, an independent charity that aims to improve healthcare in England, has found that the NHS is holding up well in some areas but is entering a period of significant risk as budgets are cut and huge organisational changes are made.

The report, titled Health Policy Under the Coalition Government follows up a 2010 report reviewing the overall performance of the NHS. It identifies areas in which patients are already feeling the impact of the challenges facing the NHS. For example, the number of patients waiting at Accident and Emergency for more than four hours has increased. There are also continuing concerns about holistic aspects of care, such as emotional support, dignity and empathy. Indeed, one-fifth of NHS acute hospitals inspected by the Care Quality Commission in 2011 did not meet essential standards in nutrition and dignity for older people.

In terms of care, the report finds that despite mortality from cancer and cardiovascular disease falling, the UK continues to have the second highest level of mortality amendable to healthcare of 16 high income countries. Alarmingly the report also reiterates that patients admitted to hospital as a medical emergency at weekends are more likely to die in hospital than those admitted during the week. NHS London has identified that if the weekend mortality rate was the same as the weekday rate there would be at least 500 fewer deaths a year in London alone. We considered this in our previous blog, “Dying for the Weekend.”

The report identifies that written patient complaints and clinical negligence claims are on the increase. The report refers to the NHS Litigation Authority findings that there were 488 more clinical negligence claims in the year 2011/12 compared to 2010/11. Although it has found that the number of reported safety incidents has risen, under-reporting of safety incidents does remain a concern. This is certainly reflected in our clinical negligence practice as we see a year on year increase in clinical negligence claims.

The financial challenge facing the NHS in saving the £20 billion needed to meet the continuing increase in demand, as well as implement crucial improvements in the quality of care given is an enormous burden.  As cracks in the service provided grow under budgetary pressures it is essential that patient care remains the top priority. This means tackling critical problems such as weekend mortality rates and cancer and cardiovascular disease related morbidity.