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NHS could face a ‘winter of woe’ unless hospitals and local authorities tackle delayed discharges, says RCS

14 Sep 2017

The Royal College of Surgeons has warned today that unless hospitals and local authorities work together to improve handover of patients and significantly reduce delayed transfers of care the NHS will struggle to free up enough hospital beds to cope with winter pressures.

NHS England performance data published today for July 2017 shows the number of delayed days for transfers of care in July 2017 was 181,692.  

Speaking at the NHS’s Health and Innovation Expo this week, Simon Stevens, NHS England chief executive, said freeing up delayed transfer of care beds would be vital to ensuring the NHS has enough capacity to manage winter pressures. Local authorities have been given delayed transfer of care targets however many councils say these are undeliverable.

Today’s data also shows 89.9% of patients on the waiting list at the end of July 2017 had been waiting less than 18 weeks. The total number of patients on the waiting list continues to grow with 4.03 million patients at the end of July 2017 (including non-reporting trusts).

Professor Derek Alderson, President of the Royal College of Surgeons, said:

“There’s a distinct chill in the air that tells us winter is creeping ever closer and today’s performance data worryingly suggests that the NHS is not ready for the pressures this will bring.

“Delayed transfers of care remain a major issue, creating logjams in hospitals, and preventing patients on waiting lists from being treated as quickly as they should be. Many of these patients will be very sick, in pain and possibly immobile. The high number of delayed days for transfers of care does not bode well.  

“Hospitals and local authorities must look carefully at what they can do to speed up the transfer of patients between different types of care. NHS leaders have already warned of a bad flu season this winter. Unless the backlog of delayed discharges begins to clear before then, it is hard to see how the NHS will cope with increased demand.  

“Last winter we saw patients waiting unacceptably long for both emergency and planned care, with far too many operations cancelled.  Skilled surgeons and operating theatre staff were also left kicking their heels because there were not enough beds available for patients to go to after surgery, wasting valuable resource.

“NHS staff are doing the best they can with the resource they’ve been given and the unabating pressure they’ve tackled this year means morale remains low. Unless patients are moved more quickly to community care and planned bed capacity is better protected, the NHS will face a winter of woe, with patients feeling the brunt of this.”

The number of patients still on the waiting list at 26 weeks (6 months) in July 2017 was 128,881 - a 30.6% increase from July 2016, when the number was 98,675. The number of patients at 39 weeks (9 months) in July 2017 was 20,719 - 45.2% increase from July 2016, when the number was 14,267.

Neurosurgery remains the worst performing recorded treatment specialty – with 82.7% waiting less than 18 weeks in July 2017. For Cardiothoracic surgery, 86.9% of patients waited less than 18 weeks in July 2017; and for Trauma and Orthopaedics, 87% of patients waited less than 18 weeks in July.

Spire Healthcare Group, which announced its half year results this morning, has seen revenue increase by 14% in the first six months of the year and suggests some of that growth may be down to patients requiring panned surgery choosing private care over the NHS.

The group runs 39 private hospitals, 10 clinics and two specialist cancer centres across England, Wales and Scotland. It is the leading private provider by volume of knee and hip operations in the United Kingdom.

Waits for A&E in July 2017, which were reported last month, missed the 95% target, with 90.3% of patients being seen within 4 hours in all A&E departments.

Notes to editors

1.  Full data available here:

2.  The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

3.  For more information, please contact the Press Office:

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