The battleground for the future of the NHS

As this 20th anniversary edition of CSJ reflects on the past two decades in healthcare, we know that the NHS has been experiencing significant winter pressures for some time. However, Matt Currall argues that we need to look beyond blaming social care to unlock patient flow and delayed discharge.

At the time of writing, the NHS is facing the prospect of an immensely challenging winter period ahead. Winter is traditionally the health service’s busiest period with an increase in coughs and colds, along with more falls and accidents caused by icy conditions, leading to a greater number of people seeking to access healthcare.

Winter 2022 is likely to be a unique one. We approach this tricky time after a summer where the health service has seen pressures at a similar level to previous winters. We also have the challenge of COVID-19 still in circulation, but with no public restrictions in place. In August, national hospital capacity sat at over 94%, with bulging waiting lists across emergency and elective care, and harrowing delays in A&E with people facing long waits in ambulances across the country.1

A focus on patient flow is therefore absolutely necessary. NHS’ data, from time  of writing, indicates that 1 in 7 (15.6%) patients in hospitals are well enough for discharge, meaning thousands of people currently residing in hospital beds could be elsewhere – either at home or being looked after somewhere else.2,3 This is a reflection of the importance of flow and the need to get it right to unlock the system.

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