Following is an excerpt from the latest annual report of the UK National Health Service. You should read the issues they face. Cost and adequate resources are at the top of the list. Some of the comments in the report may sound familiar.
The NHS employs 1.3 million people, workforce constitues half of the cost of services. There is a massive bureauocray including hundreds of boards and agencies at all levels.
Americans wait for appointments as well, but not like mentioned below and most important not when it comes to serious conditions that need care. The average time spent with GP visit in the U.K. is 8-10 minutes. The US average is about double that.
Managing health care costs and maintaining adequate resources to deliver care is an ongoing challenge everywhere.
2015-16 has been a challenging year for the NHS and for the wider Departmental Group. In financial terms, the NHS has faced significant pressures in meeting increased demand for services, and at the same time, labour cost – particularly labour headcount, has increased at a higher rate than the demand for services during the year. This has made it increasingly difficult for the Department to stay within overall spending controls.
However, this year has undoubtedly been a challenging one for the NHS. The Department’s overall performance should be viewed in the context of the key challenges facing the health and care system, including:
• demographic change, in particular the challenges of an ageing population;
• rising public expectations, particularly over the opportunities presented by new technologies; and
• the fiscal challenge of reconciling rising demand with finite resources.
Elective waiting times are monitored against the referral to treatment (RTT) incomplete pathway standard that 92% of patients still waiting to start consultant-led treatment for non-urgent conditions at the end of the month should have been waiting within 18 weeks from referral. The standard was not met in 3 months in 2015-16. The number of clock starts (demand) is estimated to have increased by 5.0% between 2014-15 and 2015-16, whilst the number of completed pathways increased by 3.8% over the same period, with the result that the waiting list continued to grow during 2015-16 to just over 3.5 million at the end of March 2016. The number of patients waiting more than 52 weeks to start treatment also increased, from 413 in April 2015 to 865 in March 2016, despite the ambition that it should be reduced to as close to zero as possible.
Early diagnosis and treatment are crucial to improving survival rates for cancer, and eight cancer waiting time standards cover different elements of the pathway to ensure patients benefit from better access to cancer services.
The standard that 85% of patients begin first treatment within 62 days of urgent GP referral for suspected cancer was not met in 11 months of 2015-16, although there were signs that performance was beginning to recover towards the end of the year. Demand continued to rise, with the number of urgent GP referrals for suspected cancer increasing by 10.9% from 1.5 million in 2014-15 to 1.7 million, and the number of patients on 62 day pathways starting first treatment increasing by 5.9% from 129,000 in 2014-15 to 136,000 in 2015-16. Delays in diagnostic tests, especially in endoscopic procedures, also added to the pressures in delivering the 62 day standard. The first cohort of an additional 200 non- medical endoscopists funded by HEE began training in January 2016, and will significantly increase endoscopy capacity to support improvement in diagnostic test and cancer waiting times.
The standard that 96% of patients should begin first treatment within 31 days of a decision to treat also includes patients who are not referred urgently by their GP but whose cancer is diagnosed in emergency or other contexts. It was met in every month of 2015-16, as were the other standards with a few exceptions.
The standard that 93% of patients should be seen by a cancer specialist within a maximum of two weeks from urgent GP referral where cancer is suspected was missed in April 2015, and the standard that 93% of patients should be seen by a specialist within a maximum of two weeks from referral for investigation of breast symptoms, even if cancer is not initially suspected, was missed in seven months of the year.
Source: Report to the House of Commons, Department of Health
Annual Report and Accounts 2015-16