Steve Barclay: 'Real sprint' needed to avert an NHS winter crisis

·5 min read
Steve Barclay - Jamie Lorriman for The Telegraph
Steve Barclay - Jamie Lorriman for The Telegraph

It will be “a sprint” to avert an NHS winter emergency, the Health Secretary has warned.

In his first interview since taking the job, Steve Barclay said hospitals were facing “very serious challenges coming down the track in the autumn”.

Mr Barclay told The Telegraph his department was in a “real sprint to get ready for September” and that decisions – including on hiring more staff from overseas – could not wait until a new prime minister was in post.

The NHS is facing a triple threat from seasonal flu, another Covid wave and the fallout from the cost of living crisis, all of which are expected to increase demand.

Mr Barclay’s comments come after it emerged that civil servants are predicting long waits at hospitals this winter, with as few as six in 10 patients expected to be dealt with at A&E departments within four hours.

Since Boris Johnson announced that he would resign, there have been concerns over a “zombie” government, with key decisions put on hold until Liz Truss or Rishi Sunak is elected as Tory leader on Sep 5.

However, Mr Barclay stressed that the NHS could not wait for solutions to the looming crisis, saying: “We have very real challenges coming down the track in the autumn and winter, and as far as I’m concerned there needs to be a real sprint within Whitehall, and particularly in the Department of Health, to get ready for September.

“Part of my role is to prepare for reasonable worst case scenarios. Obviously those pressures can come in different forms. It might be you get a bad flu, it may be Covid rates are higher than we would expect or like.

“There’s an urgency of now to prepare, particularly in areas where there’s a long lead time. The decisions need to happen now, not wait until the autumn – by which time those lead times would put the resolution at too late a stage.”

Mr Barclay was speaking after attending a civil contingencies meeting on “how we prepare for pressures across Government” this winter, including an influx of patients to the health service.

He vowed to make Whitehall “move much more quickly on decisions” and “test the political risk appetite” amongst NHS chiefs to take bolder action.

The Health Secretary has ordered civil servants to “work at pace” on proposals to “significantly increase” overseas recruitment of staff to meet the extra demand.

He wants the drive – which could see thousands more healthcare workers arrive in Britain over the coming months – to focus in particular on bolstering the social care sector.

Mr Barclay said healthcare recruitment could be expanded by hiring from countries that produce more nurses than they need, including India, Sri Lanka and the Philippines.

He added that social care could also benefit from bringing in foreign workers who have nursing qualifications but not a high enough standard of English for front line NHS work.

The language requirements, which are set independently of the Government by medical bodies, are lower for many social care roles.

Nurses need to have the same level of English regardless of whether they work in a hospital or social care setting.

There are currently 105,000 vacancies in the social care sector, according to government figures. The lack of staff is having a severe knock-on effect for hospitals, leading to delays in discharging patients from wards to free up beds.

Mr Barclay said that in turn leads to “ambulances being delayed on handover … that manifests itself with unmet need in the community”.

He has set up a task force in his department to “bring much more focus to this issue, to work at it at pace and to see what is the scope of the opportunity”.

“I have been working at pace over recent weeks to accelerate our contingency plans, to look at specific levers such as increasing significantly our international recruitment,” he said. “We don’t want people delayed on the ward – that is a bad outcome.

“A big part of my focus has been giving a lot more ministerial time to looking at the issues on delayed discharge, on social care recruitment. If there’s pressure on the system and that requires more beds in the community, those beds need the workforce to go with them.”

The Government has lifted the cap on healthcare visas, and figures show 75,963 were granted in the 12 months up to March, compared with 14,016 the year before. India was the biggest provider of workers to the sector last year, with 32,476 moving to Britain, followed by Nigeria on 11,102 and the Philippines on 9,510.

To get a visa, foreign staff must prove they have mastered English to a sufficient level and have a job offer from a recognised employer with a salary of at least £20,480.

Civil servant predictions that as few as six in 10 patients will be dealt with at A&E departments within four hours this winter, which emerged at the weekend, suggest the health service in England is on course to miss the mandatory waiting time target by a record margin.

Mr Barclay acknowledged that A&E is “a very challenging landscape at the moment”, adding that he was working on a “pharmacy first model” to ease the pressure on hospitals.

Lord Victor Adebowale, the chairman of the NHS Confederation, last week warned that the service faces a winter crisis unless “immediate action” is taken to address social care labour shortages.