NHS financial sustainability 

National Audit Office | January 2019 |  NHS financial sustainability

The National Audit Office (NAO) has produced its annual report into the financial sustainability in the NHS. It concludes that the existence of  substantial deficits in some parts of the system, offset by surpluses elsewhere coupled with growing waiting lists and year-on-year increases in waiting times, does not paint a picture that is sustainable. 

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The current funding flows in the NHS are complicated and do not support partnership working, integration and the better management of demand. Trusts also told the NAO that Sustainability and Transformation Fund payments made by NHS England have encouraged trusts to prioritise short-term gains over long-term sustainability which also resulted in reduced collaboration with other local bodies.

The NAO has made a number of recommendations to the Department, NHS England and NHS Improvement to ensure additional funding is spent wisely. This includes testing whether local plans to manage demand are realistic; ensuring key risks to delivery of the long-term plan are identified; and developing a sustainable long-term plan to support trusts in severe financial difficulty (Source: NAO).

Full report – NHS financial sustainability

Summary – NHS financial sustainability

ePub – NHS financial sustainability

NHS financial sustainability [press release]

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Making the most of your budget

Health matters: health economics – making the most of your budget| Public Health England

All local authorities and local public health teams are under budget pressures and are facing increasingly challenging decisions over what services to invest in and disinvest from. This edition of Health Matters focuses  on local authorities, NHS commissioners and healthcare providers making better evidence-based commissioning decisions, and getting the most from their budget using easy to use health economic tools, resources and core principles.

Full detail at Health matters: health economics – making the most of your budget

Video: Why is it necessary to make the economic case for investment in prevention?

The NHS 10-year plan: how much will be spent on NHS deficits?

The King’s Fund | July 2018 | The NHS 10-year plan: how much will be spent on NHS deficits?

NHS providers racked up a deficit of just under £1 billion in 2017/18. How much of the Prime Minister’s 3.4 per cent real-terms growth a year will go into removing these deficits? Not a lot is probably the answer.
(Source: The King’s Fund)  

Making money work in the health and social care system

 HFMA & PwC | June 2018 | Making  money work in the health and social care system

PwC have  worked closely with the Healthcare Financial Management Association (HFMA),  to explore what those working in both policy and practice
across the health sector think about the current mechanisms.

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Image source: hfma.org.uk

They have used their findings, and experience, to propose a number of
recommendations which they believe would facilitate the move towards place based care and support the ambitions of the Five Year Forward View.
These recommendations are particularly timely as indications are that an
announcement of a well needed, long term funding settlement for the NHS is imminent. The need for additional funds is widely recognised. The recommendations in their report would enable this funding to be put to best use for patients (Source: HFMA & PwC). 

Further details are available from HFMA here

How is the NHS performing? March 2018 quarterly monitoring report

The King’s Fund| March 2018 | How is the NHS performing? March 2018 quarterly monitoring report 

The King’s Fund has released its quarterly monitoring report (QMR) of NHS performance. Its analysis finds increased numbers of patients are facing long waits for hospital treatment, with those experiencing the longest delay often most in need of treatment. As demand for services is continuing to rise, the think tank finds it unlikely that meeting waiting time targets will become more achievable, with implications for how the NHS protects patients waiting the longest (The King’s Fund).

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Since the last QMR there has been a Budget, new planning guidance for 2018/19 and most (but not all) of winter.  The King’s Fund considers the impact of these factors together with their latest survey data sources to discuss the current position and forecast for finance and performance.

The report focuses on four key areas:

  • Finance
  • Perforamce
  • Waiting times: making the sickest wait longest
  • Looking to the future

It is available at the King’s Fund 

Sustainability and Transformation Plans: What, why and where next?

The Institute for Public Policy Research (IPPR) has published Sustainability and transformation plans (STPs): what, why and where next

The NHS is facing one of the most challenging periods in its history, with a funding gap of more than £22 billion over the coming years. And the pressure on the social care system is more acute than ever, with many councils raising eligibility thresholds and making cuts to social care budgets.

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Image source: http://www.ippr.org

Sustainability and Transformation Plans (STPs) – which are local health and care reform plans, authored jointly by NHS and local government leaders to improve outcomes and drive greater efficiency in their local area – are one of the government’s main responses to this problem. These plans rightly focus on decentralising power within the NHS, investing in leadership and relationships to drive improvements, and on local health and care organisations coming together to overcome the silos created by the 2012 Health and Care Act.

This report looks at the most promising reform solutions that have been identified by STPs, and also sets out the range of challenges that stand in the way of them realising their vision for improved health and efficiency.

Download summary here or full report here