The NHS faces “serious challenges in maintaining standards of care”, with senior managers expressing worry about having the right levels of staff, according to a new report.

The NHS Providers study of 158 health trust chairmen and chief executives also found concerns about NHS finances and the current state of mental health.

Only just over half of those surveyed were “confident” they could currently provide high-quality care, a figure down from 60 per cent last November, while fewer than one in ten said the care offered by their trust was of “very high quality”.

More than a third thought the care given to patients was “average”, while two per cent said it was of low quality.

The report said: “NHS trusts are experiencing record levels of demand for their services. At the same time, patients have higher and more complex needs.

“Many trusts are now running at capacity levels beyond the recommended norm and levels in other advanced western health systems.

” The report said for the first time, the NHS was missing all four of its key targets: three-quarters of ambulance responses within eight minutes, 95 per cent of A&E patients seen within four hour, 92 per cent of elective surgery within 18 weeks, and 85 per cent of patients seen within 62 days of referral by their GP.

The study said the NHS was in “the longest and deepest funding squeeze in its history”.

While the extra funding promised in the Conservative manifesto was welcome, spending on health would still fall significantly as a percentage of national wealth for another five years, it added.

The study also warned that the government’s commitment to tackle injustices faced by people with mental health issues was being undermined. It said the impact of increasing demand, too few staff and the failure of funding to get through to the frontline meant core mental health services were being overwhelmed.

Saffron Cordery, director of policy and strategy at NHS Providers, said: “Having the right staff with the right skills in the right place is the only way to improve mental health services.

“But mental health trust leaders are struggling to find sufficient staff to deliver their current services, let alone find new staff to extend, or innovate services.” “Unless action is taken, the Government’s ambitions for transforming mental health care will not be met.

” Professor Wendy Burn, president of the Royal College of Psychiatrists, said: “When 80 per cent of the people who run NHS mental health services are worried that they will not have enough money to deliver the Government’s commitments to improve mental healthcare, we should all listen.”

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