NHS trust leaders have cited primary and social care capacity among the ‘greatest risks’ to the provision of high-quality patient care this winter.
And around four in 10 (41%) said social care should be a top priority for the new government, while a quarter (25%) said the same about primary care.
The findings come from an NHS Providers survey of 171 NHS trust leaders working across 118 trusts covering community, mental health, hospital and ambulance services.
Almost all (98%) of the those surveyed supported the national policy agenda to shift more care from acute services into the community, as part of Labour’s plans to move care ‘closer to home’.
However, nearly three-quarters (72%) of trust leaders said they were ‘very worried’ or ‘worried’ about whether sufficient investment was being made in public health and prevention in their local area.
Trust leaders flagged the need to increase capacity in social, community and primary care to keep up with rising demand in non-acute services.
Leaders also raised major concerns about infrastructure, with almost two-thirds of trust leaders (62%) ‘very worried’ or ‘worried’ that more support and infrastructure improvements are needed to better integrate services across primary and secondary care.
Saffron Cordery, deputy chief executive of NHS Providers, warned the NHS ‘won’t get a moment’s respite’ as it faces another busy winter, adding that the health service needs to work differently to improve care for patients.
But she warned that ‘realism’ was required to assess how quickly change could be delivered.
Social care was seen as the second most common ‘risk to the provision of high-quality patient care over winter’, according to survey respondents, with just under half (49%) selecting this option.
Meanwhile, almost a quarter (23%) said the same about primary care, and 12% about community care.
Delayed discharge was seen as the biggest risk to high-quality patient care over winter, with 57% of respondents choosing this response.
Trust leaders also said supporting investment and reform in social care should be one of the government’s top priorities for the 10-Year Health Plan.
England’s chief nursing officer (CNO), Duncan Burton, recently appealed to primary and community care nurses to help inform the government’s 10-Year Health Plan by sharing examples of good practice and innovation.
Responding to the report, executive director of the Royal College of Nursing (RCN) in England, Patricia Marquis, said: ‘A severely depleted nursing workforce is going into winter running on empty, whilst trust leaders sound the alarm that they can’t guarantee high quality care. This is a deeply worrying moment for patients and for plans to tackle waiting lists.
‘Nothing can be done without investment in the skilled nursing staff our patients need.’
Ms Marquis stressed that major staff shortages are holding reforms back and urged ministers to ‘wake up to the crisis’ in nursing and deliver new investment.
Her comments come a day after the RCN revealed that an increase in nurses quitting the profession early will make the government’s planned NHS reforms ‘impossible to deliver’.
Last month, the Care Quality Commission (CQC) found that the primary care workforce in England is facing ‘unsustainable’ pressures, while community health services are struggling with increasing waiting lists and insufficient beds.
In September, Lord Ara Darzi’s review into the NHS highlighted the escalating problem of falling community nurse numbers that had left the NHS in a ‘critical condition’.
Health minister Karin Smyth said: ‘We inherited an NHS that is broken, but we are fixing the foundations with a nearly £26bn boost for the NHS over this year and next.’
She reiterated the government’s promise of a 10 Year Health Plan that she said will help ‘build an NHS that is fit for the future and delivers for patients all year round’.
