Hospitals braced for `toughest year'

Waiting times are likely to lengthen and new developments face postponement as the NHS faces its toughest year financially since the NHS reforms came in, health authorities and trusts warned yesterday.

A survey undertaken by the National Association of Health Authorities and Trusts (Nahat) shows that at least a quarter of trusts will only break even by cutting services and increasing waiting times for non-urgent admissions. At least one in five reckon they are unlikely to break even, and many report that rising demand for emergency services is eating into funds for waiting-list procedures.

"Generally acute trusts report that the rise in emergency admissions will have an effect on elective services, so that in-patient waiting times will either begin to increase or that planned reductions will not be achieved," the survey of 50 health authorities and trusts shows. One trust has calculated that for some conditions waiting times will escalate from 10 to 18 months.

Measures which could ease the pressures - for example merging duplicate services - are being held up by political sensitivity in the run-up to the general election, authorities report.

"It is no secret that this is the toughest year financially since the NHS reforms came in," Philip Hunt, director of Nahat said. "We have 1.1 per cent real growth and that isn't enough. Ideally, we need 3 per cent and we can manage on 2 per cent, but 1.1 per cent is real trouble."

The picture will vary locally, Nahat believes, and some developments in services will still take place. But "very difficult choices are having to be made", Mr Hunt said. "Whilst waiting times will fall or remain on an even keel in many places, in some parts of the country they are threatening to slip back."