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.
There is a great deal of focus in the health and care system on measuring the quality of care being provided. But what about care that isn’t provided at all? | The King’s Fund Blog
We have published several reports this year highlighting pressures in community-based services, including social care and district nursing. These pieces of research raised concerns about changes to the availability and quality of services as a result of rising demand and insufficient funding and staff numbers. The reports also raised concerns that these pressures might be leading to rising levels of unmet need.
Unmet need is difficult to define, and harder still to measure. This would be true in any setting, but particularly for services like district nursing that are delivered in people’s own homes. People who are not receiving district nursing care but would benefit from it, or those who are receiving some care but require more than they are currently getting, are often out of sight. There are no overcrowded waiting rooms or queues to bring this unmet need to light.
Amid drastic cuts to health visiting services, I’m struggling to help the vulnerable families I see every day | The Guardian Healthcare Network
Health visitors don’t always get good press at the school gates or toddler groups. Among my fellow nursing friends, the standing joke is that I spend my day simply weighing babies. I guess as a result it’s not hard to see why in some areas the value placed on health visiting has fallen so far that the service will be cut completely.
At the moment most councils are reviewing the funding for health visiting amid drastic cuts to public health budgets. Cumbria and Staffordshire are planning on cutting health visiting posts and a number of other NHS trusts have job freezes and have discussed redundancies. NHS Digital reported this year that the number of health visitors dropped in UK by 433 posts.
While perhaps there may be some truth in the comments I so often hear, the reality of health visiting feels very different.
Some recent developments – such as the ‘footprints’ proposed for delivering STPs and the potential hospital savings identified by Lord Carter – are seen as providing real chances for improvement. However, respondents remain concerned about the continuing decline in staff morale, and pessimistic about the state of finances within individual trusts and the health service in general.
Clinical commissioning groups’ efficiency targets have risen by over a quarter this year in a sign that the financial strain on the health service is moving beyond the provider sector.
CCG QIPP targets up by more than 25 per cent in a year
Efficiency requirement shows financial squeeze is spreading beyond provider sector
Highest QIPP targets linked to CCGs in deficit
Many plans still relying on A&E activity reduction
CCG quality, innovation, productivity and prevention targets, published by NHS England, show that commissioners are aiming to save £1.8bn this financial year through their efficiency plans – an increase of 28 per cent on last year.
The data also shows the CCGs with the biggest QIPP challenges this year have targets to save more than 6 per cent of their annual funding allocation. In 2014-15, the largest QIPP targets were less than 5 per cent of allocation.