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).
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.
CCG Improvement and Assessment Framework 2017/18 | NHS England
This updated framework describes the CCG annual performance assessment and the metrics that will inform that assessment for 2017/18; it replaces the Improvement and Assessment framework (IAF) for 2016/17. The framework is accompanied by a technical annex which provides the detail of the construction and purpose of each of the indicators in the framework.
This report explores the accountability and performance management arrangements for CCGs and looks at the implications of STPs and accountable care systems for these| The Nuffield Trust
The NHS has developed systems to hold both providers and commissioners of NHS services to account. These have arguably become more complex with the introduction of 44 sustainability and transformation partnerships (STPs). This report from the Nuffield Trust draws on analysis and insights from the current system, and explores the challenges and opportunities presented by STPs for accountability in the NHS. It is based on 13 interviews with senior CCG leaders and NHS England policy makers which took place in September 2016.
The report also explores how commissioners and providers respond to different approaches to accountability and performance management. The report then considers the implications of this learning for the future development of STPs, accountable care organisations and accountable care systems.
This document lists the overall rating for each of the 209 CCGs as part of their annual assessment under the CCG Improvement and Assessment Framework (CCG IAF). Full details of each an individual CCG’s performance against the framework’s indicators are available on the MyNHS website.
This Commons Library briefing paper looks at the commissioning of specialised services by the NHS in England, for patients with rare or complex conditions | House of Commons Library
How the commissioning process works is set out in further detail, as well as analysis of the financial management and transparency of specialised commissioning, and recent reforms introduced by NICE and NHS England, including reforms to the Cancer Drugs Fund.
The specialised commissioning budget for 2017/18 is £16.4 billion, 14.9% of the total NHS budget, and is set to rise to 15.8% by 2020/21 to reflect the increasing use of new treatments for previously untreatable conditions.
In its 2016 report, the National Audit Office (NAO) highlighted problems that NHS England had experienced in living within its budget. Some of the reasons for this included an underestimation of the budget required to effectively commission services when NHS England took over commissioning responsibility in 2013, as well as a lack of effective data on how services are commissioned on a regional basis, and problems with effective negotiation of prices with pharmaceutical companies.
This briefing paper looks in details at some of the issues highlighted by the NAO, and recent changes to the commissioning process that allow for a greater degree of cost control.
This latest quarterly monitoring report from The Kings Fund finds that NHS is now planning to delay or cancel spending in half of local areas this year to meet financial targets. The survey of NHS trust finance directors suggests that NHS finances have improved over the last quarter of 2016/17 but whilst progress has been made in reducing agency spending, the underlying financial position remains a source of concern with many trusts having relied on one-off actions to improve their financial position.
The 2017/18 financial year looks set to be another difficult one for the NHS. While trust finance directors are more optimistic than at this time last year, 43 per cent of them expect to overspend their budget and a similar proportion (46 per cent) are concerned about meeting financial targets. This lack of confidence extends to the commissioning sector, with only one in five CCG finance leads confident they can achieve financial balance this year.
This quarterly monitoring report combines publicly available data on selected NHS performance measures with views from NHS finance directors and clinical commissioning group finance leads. The report now also includes views from general practitioners and practice managers, and unpublished activity data.