UK: A Year In The Life Of The NHS

Last Updated: 17 January 2015
Article by Karen Taylor

Most Read Contributor in UK, August 2017

The past year has been one of continued and unrelenting challenges for the NHS with healthcare dominating the news and public policy agenda throughout 2014.

In the face of year-on-year increases in demand, the NHS has continued to provide care for increasing numbers of patients. However, as a result of funding and capacity constraints many NHS organisations are now reporting financial deficits, staff shortages and a deterioration in performance against NHS targets. Other challenges, including escalating crises in primary and social care, have become more prominent. As we enter the 2015 election year the NHS faces a mounting array of financial, workforce, performance and quality challenges compounded by increasing patient expectations and regulatory scrutiny and the certainty that it will be one of the key, if not the key, election issue.

In 2014, the NHS continued to enjoy high levels of public satisfaction with many examples of heroic actions and important breakthroughs in the care provided, but it also attracted more than its fair share of criticism, mostly around quality, equity and access to services. Given the almost universal acknowledgement of the need to provide healthcare free at the point of need, there is political acceptance that more funding will be needed, albeit differences of opinion as to how much and where the funding will come from. However, many of the solutions to the perceived NHS crisis appear to focus more on the supply side (changing organisational structures and increasing the numbers and pay of NHS staff), rather than on moving the management of demand upstream and working differently. In considering how things might be done differently in 2015, notwithstanding the hiatus that the election is likely to create, I thought it might be interesting to reflect back on the key events of 2014, these include:

  • January - the ongoing debate about care.data, which started in January 2014 has continued throughout the year but with limited evidence, as yet, of a workable solution.
  • February - the first anniversary of the report on the Francis Inquiry continues to reverberate across the NHS including being the main driver behind the increasing numbers of nurses employed by NHS hospitals during 2014.
  • March - the Chancellor's Budget, confirmed protection of the NHS budget but introduced further spending cuts to most non-protected departments, including local government, leading to tighter eligibility criteria for adult social care. At the same time a pay dispute erupted when the NHS Pay Review Body's recommendation of a one per cent increase was rejected. Instead, a two-year deal was put forward offering a one per cent increase to those staff who were not entitled to incremental rises.
  • April - Simon Stevens took over the reins at NHS England. The Prime Minister committed to training 10,000 more community nurses over the next six years, as part of plans to shake up general practice.
  • May- the Care Bill received Royal Assent. Health Education England and the Nursing and Midwifery Council launched a major review of pre- and post- registration education and training the Shape of Caring review (findings due in early 2015).
  • June/July - as the NHS moved into the summer months, the anticipated slowdown in demand failed to materialise and the NHS continued to face growing demand for services, leading to increasing concerns over the solvency of some NHS provider organisations. Meanwhile the National Institute for Health and Care Excellence published guidelines on safe staffing levels in adult in-patient wards suggesting that there should be no more than eight patients per registered nurse during the daytime or fewer than two nurses present during any shift.
  • August - analysis by a number of academic and research institutions added to the growing body of evidence of the need for further funding for the NHS which in turn led to an announcement in the Autumn Statement of additional NHS funding of £2 billion in 2015/16.
  • September - the annual party conference season saw all political parties holding high profile debates on the problems and potential solutions for the NHS. At the same time concerns over the growing Ebola outbreak in West Africa escalated and Public Health England announced a national response.
  • October -the publication of Simon Steven's Five Year Forward View, welcomed by many commentators as a much needed strategy document to frame the future direction of health policy. While there is a general consensus of support for the proposals, the political parties have conflicting views on how to bridge the funding gap. October was also the month when thousands of nurses and midwives took part in strike action -the first time in the Royal College of Midwives' 133 year history that its members took strike action.
  • November - six months before the general election, coincided with increasing evidence of a growing crisis in general practice. A legal duty of candour came into force in England, requiring NHS organisations to admit when patient safety errors have occurred.
  • December - the NHS was firmly ensconced on the front page of most newspapers with stories of "no room at the inn", excessive breeches in waiting time, financial bail outs, cancelled operations and long waits to see a GP and NHS dentist.

The above represents only a small selection of the numerous defining moments of 2014 but, as we head into the General Election in 2015, there is an increasing feeling of Deja-vu. In 1997, the Labour government was elected on a platform of '24 hours to save the NHS' and what followed was six per cent year-on-year increases in NHS funding, between 2002 and 2008, with the recruitment of many more staff, paid more, but with little success in getting them to work differently. As we enter 2015, any funding increases will be limited, so it will be important to identify and understand how to change ways of working and improve the economy, efficiency and effectiveness with which NHS resources are used.

We also need to find a way of balancing the media coverage, by recognising the vast improvements that have been seen over the past 15 years. For me, these include: large scale investment in the NHS infrastructure; tremendous advances in medical imaging, new life extending treatments for many diseases; improved awareness of and approaches to health and safety risks; and better patient engagement and involvement. Overall, there is a need for more recognition to be given to all the many positive things that happen every day across the NHS and the sheer resilience, commitment and dedication shown by its staff in the face of unrelenting demand.

Indeed in every issue I've researched over the past 15 years there is evidence of innovative ideas being tested and new models of care adopted, but what has continued to undermine progress is the wider scale adoption of this good practice. With advances in data analytics and technological innovation, access to this evidence base has never been easier at the same time the transparency agenda means failing to adopt and comply with good practice will be ever more evident. So let's hope this time, whatever the political landscape, the NHS will truly start to work differently and preserve its place in the nation's hearts.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Authors
 
In association with
Related Video
Up-coming Events Search
Tools
Print
Font Size:
Translation
Channels
Mondaq on Twitter
 
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
 
Email Address
Company Name
Password
Confirm Password
Position
Mondaq Topics -- Select your Interests
 Accounting
 Anti-trust
 Commercial
 Compliance
 Consumer
 Criminal
 Employment
 Energy
 Environment
 Family
 Finance
 Government
 Healthcare
 Immigration
 Insolvency
 Insurance
 International
 IP
 Law Performance
 Law Practice
 Litigation
 Media & IT
 Privacy
 Real Estate
 Strategy
 Tax
 Technology
 Transport
 Wealth Mgt
Regions
Africa
Asia
Asia Pacific
Australasia
Canada
Caribbean
Europe
European Union
Latin America
Middle East
U.K.
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement

Mondaq.com (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of www.mondaq.com

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about Mondaq.com’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.

Disclaimer

Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.

Registration

Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to unsubscribe@mondaq.com with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.

Cookies

A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.

Links

This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.

Mail-A-Friend

If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.

Security

This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to webmaster@mondaq.com.

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to EditorialAdvisor@mondaq.com.

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at enquiries@mondaq.com.

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at problems@mondaq.com and we will use commercially reasonable efforts to determine and correct the problem promptly.