The NHS can be a scary place. Never events, a missed waiting time target… a surprise visit from the Secretary of State for Health. But if you’re looking for a real fright this Halloween look no further than these charts selected by the team at Incisive Health. But beware these spine-chilling graphs aren’t for the faint hearted…

Antibiotic apocalypse

Antibiotic resistance, whereby bacteria develops a resistance to antibiotics through spontaneous genetic mutation, is a growing worry for healthcare professionals around the globe. It’s been 30 years since a new class of antibiotics was developed, which means that health systems are taking a number of steps to maintain the effectiveness of existing antibiotics.

In a world where we rely on antibiotics to treat infections after life-saving transplants and other surgeries, childbirth and chemotherapy, the threat of antibiotic resistance is difficult to overstate. In 2014, a major report warned that if action isn’t taken drug resistant infections could kill 10 million people a year worldwide -more than currently die from cancer -by 2050. Last month, the UK’s Chief Medical Officer ProfessorDame Sally Davies went so far as to suggest that Britain could face a “post-antibiotic apocalypse” and the “end of modern medicine” because of antibiotic resistance.

An alarming rise in deaths in the north

A study of premature mortality in northern and southern England between 1965 and 2010 revealed excess mortality among 25-44 year olds has “risen alarmingly” in the north since the mid-90s. This is on top of persistent inequalities that have seen 1.2 million northern excess deaths under the age of 75 since the 1960s.

To address this problem the report suggests rebalancing the economy between the north and south of England to ameliorate the divide that has persisted since the days of Disraeli.

England’s STI capital

According to figures from Public Health England, London accounts for a quarter of all cases of sexually transmitted infections(STI)in the UK. More than 117,500 new STIs were diagnosed in London residents in 2016, meaning that over 300 new STIs were diagnosed per day. While across England diagnosis rates for many STIs, such as gonorrhoea (up by 11 per cent between 2014 and 2015) and syphilis (up by 20 per cent) have risen too.

At the same time, Genito-urinary medicine (GUM) services, which provide STI testing, are under sustained financial pressure across the country. In 2015/16 the public health grant to local authorities was reduced by 6.7 per cent and across England spending on STI testing and treatment fell by almost four per cent between 2013/14 and 2015/16, as local authorities cut back.

A worry on the wards

In June, the Health Foundation revealed a 96% drop in the number of nurses registering to practice in the UK since the Brexit vote in July 2016. The figures obtained by Freedom of Information request showed that just 46 EU nurses registered to be eligible to work in the UK in April 2017, compared with an average of 1,000 per month before the Brexit vote in 2016. But this isn’t the only challenge facing NHS managers looking to recruit nursing staff. Nursing training places have been cut by more than ten per cent since 2010, with Health Education England now projecting an annual shortfall of nurses up to 2020. While the Government aims to reverse this trend there remains a chronic shortage of nurses in the UK.

Bad news on beds?

In September, the King’s Fund revealed that the total number of NHS hospital beds has more than halved over the past 30years, falling from around 299,000 to 142,000. While most advanced healthcare systems have reduced bed numbers, the UK currently has fewer acute beds relative to its population than almost any other advanced health system. Increasingly it appears that this reduction has led to a growing shortage of beds.

In 2016/17, overnight general and acute bed occupancy averaged 90.3 per cent and between January and March 2017, it reached 91.4 per cent –the highest recorded for any quarter. As more than one patient can use a bed per day, the Royal College of Emergency Medicine recently warned that daytime occupancy rates for general and acute beds frequently exceeded 100 per cent.

Tariff troubles

This month, the Nuffield Trust recently brought to life the cuts in the amount that NHS organisations are paid per patient since 2010 and the impact on hospital finances. In simple terms hospitals are each paid a set amount for each patient they treat using a national tariff listing prices for procedures. Since 2010 the amount paid for procedures on the tariff has been cut 4% in real terms year on year –to encourage efficiency savings.

This means that a hospital will now get £937 in cash to treat a patient they would have received £1000 for in 2010 (the green line). But when you add inflation into the mix even this £937 is closer to £760 (the blue line). While the shaded section of the graph projects the gap between cost and payment narrowing in the future, the Nuffield Trust warns that this is dependent on holding down inflation and there are worrying signs that this might not be possible.

More mixed sex breaches

Last month, a new report from the House of Commons library reviewed a range of indicators to better understand the continuing pressure on demand and performance in the NHS. One indicator charts the long running aim of eliminating mixed-sex accommodation in NHS hospitals. As far back as 1997, Tony Blair called the elimination of mixed sex wards “not just a question of money. It’s a question of political will.”

Worryingly the chart above shows that so far in 2017 there have been close to 6,000 unjustified mixed-sex breaches, up 58% in comparison to 2016. But breaches are still 80% lower than for the same period in 2011.