Where next for the NHS?

Generic image of a pensioner The ageing population is creating challenges for the NHS

Across 1,781 pages, the public inquiry into the Stafford Hospital scandal has forensically set out what is wrong with the NHS system.

The report detailed a culture whereby the needs of patients were too often sidelined for the self-interest of the system.

Inquiry chairman Robert Francis was at pains to point out that change did not need major reform and reorganisation.

Instead, he said it was up to people to make a difference from the "cleaners and porters to the secretary of state".

But the question that has not been asked is: will they have the time?

Pressure on the NHS - and hospitals in particular - is growing all the time.

The ageing population and growth in chronic conditions, things like heart disease and dementia, means the health service has found itself having to manage patients rather than cure them.

That requires time. But that is the very thing staff all too often say they don't have.

Budget squeezes

The result is that many people find themselves having an emergency episode and end up in hospital.

Nearly two thirds of patients admitted to hospital are over the age of 65.

By far the most problematic for the health service is the very elderly - those over 85.

Once admitted they spend 11 days on average in hospital - nearly four times longer than working-age adults. Once discharged they have the highest chance of readmission.

Evidence suggests they would be better cared for at home, but that requires investment in NHS community services, such as district nursing, and social care support from councils.

Both are facing squeezes on their budgets in the current climate.

Towards the end of last year the Royal College of Physicians published a report called Hospitals on the edge?

It argued cultural change needed to be accompanied by a whole new approach to care whereby hospitals were seen as specialist centres.

But when the NHS tries to do that it faces problems as the furore over the reorganisation of hospitals in south London showed last week when thousands took to the streets to oppose changes.

It means the health service is caught between a rock and a hard place. Expectations are rising and care is getting more complex. Change is needed, but difficult to implement.

One thing is for sure, the Francis inquiry has ensured there will be no hiding place for the NHS as it battles to rise to the challenge.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

Does the (care) cap fit?

A cap on care costs is being introduced in England. But many people will not benefit from it - and those that do could still end up paying for their care even when they hit it.

Read full article

More on This Story

More from Nick


This entry is now closed for comments

Jump to comments pagination
  • rate this

    Comment number 159.

    As a front line NHS worker I find that there are 2 main problems: excessive paperwork (mainly introduced to provide "accountability" but actually hindering staff to spend time caring for their patients) and a completly insane pt to staff ratio. A trained nurse who is not answering a buzzer for a commode because she is dealing with 10 other pts at the same time is not un-caring, she is overworked.

  • rate this

    Comment number 220.

    ''Pressure on the NHS - and hospitals in particular - is growing...''

    Get it right:-

    The pressure is NOT on the FAT CATS at the top.... ALL of the pressue is on the poor nurses who are being told that they may face court of they don't admit mistakes... and who are being subjected to a massive rise in complaints against them from compensation-culture parasites jumping on this bad-press bandwagon

  • rate this

    Comment number 97.

    71.Some Lingering Fog

    "The NHS is an institution that has just been proved to cause thousands of unnecessary deaths and yet people still carry on defending it. Amazing!"

    What about all of the lives it has saved?

  • rate this

    Comment number 2.

    Where next ? I'll give you a clue : it's not privatisation, Jeremy Hunt.

    The British people do NOT want the NHS to be privatised.

  • rate this

    Comment number 261.


    The vast majority want things to change in the NHS. I am one of its supporters, I owe my life to it. But when you get comments about privatizing the NHS and the good doctors and nurses being called unionized scroungers who don't do a proper job. Then I feel it is my responsibility to fight your corner from which ever direction such scurrilous attacks may come from. I'm on your side.


Comments 5 of 340



Copyright © 2015 BBC. The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.