Now, where are those matches at the end of this tunnel?

Abstract

The NHS is punch-drunk, lurching from crisis to crisis and poorly protected against the threat of a final flurry of knockout blows. Resources and funding consistently fail to keep pace with an inexorable increase in clinical demand; an imbalance severely compounded by a funding structure, designed in the 1940s, that patently cannot cope with the exigencies of the second decade of a new millennium. Blurred responsibilities between health and social care have resulted in overwhelmed emergency departments, inappropriate hospital referrals and bed shortages – and the rising tide of ‘black alerts’ should come as no surprise to anyone. Neither should the fact that morale among NHS personnel is now at an all-time low and we are faced with increasingly worrying deficits in staff recruitment and retention. The majority of hospital trusts and virtually all clinical commissioning groups (CCGs) in England are reported to be in dire financial straits, Simon Steven's 5-Year Forward Plan is now a 3-Year Forward Plan (having shown little sign of progression during the first 2 years of its existence) and the threat of industrial action by junior …