NHS patients still face postcode lottery for urgent care, damning MPs’ report finds
Patients in need of urgent medical attention are still subject to a postcode lottery where the quality of care depends on where they live, MPs have warned.
There are still wide variations in ambulance response times depending on region, MPs on the Public Accounts Committee (PAC) said, as they found performances in key services had fallen “far below the standard the NHS says patients should expect and receive”.
It said that despite the NHS having “more money and staff than ever before”, it had made “poor use” of its resources to improve access for patients.
The committee said that although the NHS budget in 2023-23 came to £152bn – £28bn more than in 2016-17 – the performance of urgent and emergency care services “has been deteriorating for many years”.
Productivity, which had been improving before the COVID-19 pandemic, subsequently fell 23% over the two years from 2019-20 and 2020-21, the MPs noted.
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The PAC report comes after the NHS waiting list in England hit a record high, with an estimated 7.75 million people waiting to start treatment at the end of August – up from 7.68 million in July.
The committee’s inquiry also examined delays in hospital discharges, which increased to an average of 13,623 patients in the fourth quarter of 2022-23 from 12,118 people during the same period the previous year.
Dame Meg Hillier MP, chair of the committee, said: “Anyone who has had recent contact with the NHS knows it is in crisis.
“Patients suffering long waits and hard-pressed staff working in a system which is not delivering deserve better. The PAC’s role is to analyse the underlying numbers, and attempt to provide a ‘get well soon’ plan for the NHS.
“The government and health system need to be alert to the serious doubts our report lays out around the workforce crisis, both the approach to tackling it now and the additional costs of funding it in the future.”
The PAC report found that people in some parts of the country are having to wait, on average, more than three minutes longer for an ambulance to arrive when they are facing a life-threatening emergency.
In 2021/22, average ambulance response times for the most serious incidents, including cardiac arrests, varied from six minutes 51 seconds for the London Ambulance Service to 10 minutes 20 seconds for the South Western Ambulance Service.
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Ambulances aim to respond to the most serious life-threatening injuries and illnesses in an average time of seven minutes.
Along with variations in ambulance response times, the report also highlighted issues with sending patients home when they no longer need hospital care.
The length of stay in the worst-performing areas for discharging medically fit patients is more than double that of the best-performing areas, according to the report.
“Not enough [is] being done to address the systemic issues with discharges that lie within the gift of the NHS and its hospitals, and which cannot be blamed on external factors,” the MPs said.
“The NHS has not met targets for ambulance handovers since November 2017 and for A&E waits since July 2015, with wider declines in performance across the board.”
Meanwhile, they said the NHS’s long-term workforce plan includes only a commitment of an additional £2.4bn to cover training costs for the first five years of the 15-year plan.
The MPs said they were “unconvinced” by NHS England’s approach to address workforce shortfall, saying its desire to retain 130,000 staff who would otherwise leave over the next 15 years was an “aspiration which seems highly doubtful”.
Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: “While this report includes data which is more than two years old and coincided with a once-in-a-generation pandemic, it is right to note the NHS has been under increasing pressure with staff experiencing record A&E attendances, hospitals fuller than at any point in their history and with thousands of beds taken up each day, in part, due to pressures in social care.
“It is testament to the hard work of staff and results of our NHS winter plan – rolling out 800 new ambulances, 10,000 virtual ward beds and work towards 5,000 extra core beds – that waiting times for ambulances, 999 calls and in A&E have improved across the country during this financial year.
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“This progress has come as the NHS has committed to delivering £12 billion of annualised savings by 2024/25 – all while dealing with more than 100,000 staff posts being vacant.”
Royal College of Nursing Director for England, Patricia Marquis added: “Another day, and yet another report into failing NHS services that cannot keep patients safe.
“Nursing staff have been sounding the siren on staff shortages for years, but the government remains more focused on soundbites than solutions.
“We need the government to take urgent action, to stop our nursing staff leaving the profession. Patient care demands it. We are crying out for funding and detail on the workforce plan – there is still very limited progress on closing the gap in nursing vacancies.”
The Department of Health and Social Care has been approached for comment.
Counter-terrorism police are investigating after an incident involving a crossbow and a firearm left two women injured in Leeds.
Police were called to Otley Road at 2.47pm on Saturday to reports of a “serious incident involving a man seen with weapons”, West Yorkshire Police said.
Officers arrived at the scene to find two women injured – and a 38-year-old man with a self-inflicted injury. All three were taken to hospital, with the man held under arrest, but their injuries are not believed to be life-threatening.
“Two weapons have been recovered from the scene, which were a crossbow and a firearm,” Counter Terrorism Policing North East said in a statement.
The incident happened on the ‘Otley Run’ pub crawl, with one venue saying it was closed for the evening due to “unforeseen circumstances”.
Officers guard one of the crime scenes
Officers inside the cordon in Leeds
Counter Terrorism Policing’s statement added: “Due to the circumstances surrounding the incident, Counter Terrorism Policing North East have taken responsibility for leading the investigation with the support of West Yorkshire Police.
“Extensive enquiries continue to establish the full circumstances and explore any potential motivation.”
Home Secretary Yvette Cooper described it as a “serious violent incident” and said she was being kept updated by police.
“Thank you to the police and emergency services for their swift response,” she said. “My thoughts are with the victims and all those affected by this attack.”
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Wrexham AFC have been promoted for the third season in a row.
The North Wales-based side has gone from the National League to the Championship in just three seasons, under its Hollywood owners Ryan Reynolds and Rob McElhenney.
Wrexham were second in the table and had a run of eight games unbeaten ahead of their match against Charlton Athletic on Saturday, which they won 3-0.
Wrexham’s James McClean lifts the League One trophy. Pic: PA
Wrexham’s Dan Scarr celebrates with the fans on the pitch after Wrexham won promotion to the Championship. Pic: PA
It is the first time any club has been promoted for three consecutive seasons within the top five tiers of English football.
The third oldest association football club in the world, Wrexham AFC was bought by Reynolds and McElhenney in 2020, and has since been the subject of a Disney+ documentary, Welcome To Wrexham.
Reynolds, wearing a Wrexham sweatshirt, and McElhenney were pictured celebrating each goal, and after the game, as the fans came onto the pitch at the SToK Cae Ras (Racecourse Ground) to celebrate the victory with the players.
Wrexham co-owners Rob McElhenney (L) and Ryan Reynolds and Ryan’s wife Blake Lively, before the match. Pic: PA
Both stars came onto the pitch after the supporters returned to the stands.
Speaking to Sky Sports, McElhenney praised those behind the scenes, referring to “so many that don’t get the credit they deserve, people who aren’t talked about”.
Reynolds said bringing success back to the club “seemed like an impossible dream” when they arrived in North Wales in 2020.
Wrexham’s Sam Smith celebrates in front of the fans after Wrexham won promotion to the Championship. Pic: PA
He put the three promotions down to “the coaching staff, the greatest dressing room” and an “all for one, one for all” attitude throughout the club, adding he was “speechless with their commitment and their emotion”.
As for the mouth-watering prospect of another promotion to the promised land of the Premier League, the pair agreed it was “for tomorrow”, before ending the interview with a joint mic-drop.
Veteran striker Steven Fletcher said, “as soon as I came to this club, I knew it was something special. We want to go again. We’ll reset in the summer, take a break and go again”.
“It has been a success.”
Just Stop Oil (JSO) insists it’s been “successful” – as its members ceremoniously hang up their orange high-vis vests during a march in central London.
Since the group formed three years ago, it’s drawn attention and criticism for its colourful, controversial protests, which ranged from disrupting sporting events to throwing soup on Vincent van Gogh’s Sunflowers, and climbing on gantries over the M25. It sprayed orange paint over Stonehenge, and cost police forces tens of millions of pounds.
Those days are now behind it; to the relief of many.
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As a few hundred activists marched through London on Saturday, blocking roads as they went; taxi drivers blared their horns and football fans shouted abuse from the pavement.
The PA News Agency filmed the moment a white minivan seemed to drive towards a group of protesters blocking the road.
Protesters shouted “I’m being pushed back!” to police, while the driver could be heard shouting “What about my right to get home?” to the officers gathered.
But JSO never set out to be popular. And it believes its tactics – though hated – have been successful; thanks to the new Labour government’s commitment to not issue new oil or gas exploration licences.
That’s why, it says, its ceasing direct action.
JSO hangs up its high-vis jackets in central London on Saturday
A washing line of high-vis jackets signifies JSO’s disbanding
“This moment marks the success of the JSO campaign – our demand was to end new oil and gas licences and that is now government policy.
“As a result of which four billion barrels of oil are being kept under the North Sea. The campaign has reached a natural end.”
Dr Oscar Berglund, senior lecturer in international public and social policy, disagrees that JSO is disappearing because it’s been “successful”.
He told Sky News policing strength and public perception might have more to do with it.
“They have very low levels of popularity. About 17% of the British population are kind of broadly supportive of what Just Stop Oil do. And that’s too low to recruit.
“It’s difficult to recruit members to something that is that unpopular, and then that a lot of people for good reason I think have kind of stopped believing in that kind of disruption as a means to achieve meaningful change.”
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One thing it did change is the law.
Policing commentator Graham Wettone tells us: “Obstruction of the highway, obstruction of rail networks for example, these are specific offences now.
“It’s given the police more tactics, more methods, more offences they can consider, even stopping and searching somebody who may have something to either lock themselves on or glue themselves to something.”
A JSO activist holds a picture of an imprisoned colleague
Emma Smart was held in prison for her activism with both Insulate Britain and Just Stop Oil.
“The high-vis might be going away,” she tells me, “but we aren’t.”
“These people aren’t going anywhere, we are still committed, dedicated, terrified by the failings of this government and governments around the world.”
JSO activists throw orange paint at van Gogh’s sunflowers
Orange smoke set off by JSO protesters at Stonehenge
She hopes for a time of reflection before it returns in a new form but says the need for climate activism is stronger than ever.
She also believes that while most people dislike JSO tactics, it still raises awareness of the cause and might even push people to more moderate campaign groups.
Just Stop Oil came behind other, similarly controversial climate campaign groups like Insulate Britain and Extinction Rebellion, and as it says goodbye, its disruptive methods have been seized upon by other organisations like the Pro-Palestinian Youth Justice.
The infamous Just Stop Oil orange vests might be going away, but the individual activists, their cause and campaign tactics feel here to stay.
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