Financial challenges facing the NHS

The Healthcare Financial Management Association (HFMA) has published NHS financial temperature check: finance directors’ views on financial challenges facing the NHS in England. 

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This briefing draws on the responses of finance directors of trusts and foundation trusts and chief finance officers of CCGs.  It finds the financial performance of the NHS remains under significant financial pressure.

Trusts reported a combined deficit of £791m in 2016/17, after receiving additional funds of £1.8bn from the sustainability and transformation fund (STF).

The performance of CCGs, based on month 11 forecasts, looks better than that of trusts with a forecast in-year underspend of £250m, but this is after the release of the £800m risk reserve to CCGs’ bottom line.

Full document: NHS financial temperature check – briefing July 2017

Additional link: NHS Providers

The rising cost of clinical negligence: who pays?

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The Medical Protection Society estimates that clinical negligence costs in the NHS have increased by 72% over the last five years and that costs could reach £2.6bn a year by 2022.

It argues that there should be reasonable compensation for patients who suffer harm due to clinical negligence but that this must be balanced against society’s ability to pay. The report makes recommendations for legal reforms around clinical negligence compensation.

More detail: Clinical Negligence Costs: Striking a balance

 

 

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

 

Department of Health group accounting manual 2017 to 2018

Mandatory annual reports and accounts guidance for DH group bodies.

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The Department of Health group accounting manual (GAM) includes mandatory accounting guidance for DH group bodies (including clinical commissioning groups, NHS trusts, NHS foundation trusts and arm’s length bodies) completing statutory annual reports and accounts for 2017 to 2018.

The GAM is approved by the HM Treasury Financial Reporting Advisory Board. It is based on the 2017 to 2018 Treasury financial reporting manual, adapted for the NHS.

There will be additional guidance updates to the GAM later in the year, which must be treated as having the same status as the GAM itself. The additional guidance will be contained in a single document, which will be updated as further issues arise.

Changes affecting the NHS

NHS Confederation has published What comes into force in April 2017?

This briefing summarises new measures, requirements and legislative changes coming into force this month that will affect NHS organisations, staff, patients and service users across England. It covers arm’s length bodies, charges, e-prescribing, finance, general practice, innovation, integration, personal health budgets, quality, reconfiguration and workforce.

NHS finances and consultant productivity

The Health Foundation has published A year of plenty? An analysis of NHS finances and consultant productivity.

This report analyses the finances of NHS providers and the consultant productivity of acute NHS hospitals, drawing on their annual accounts from 2009/10 to 2015/16 and links this to wider NHS data. It shows that NHS providers saw relatively little of the income growth for the NHS as a whole, and that productivity for consultants and the wider workforce in acute hospitals has been falling.

Understanding NHS financial pressures. How are they affecting patient care?

The Kings Fund has published ‘Understanding NHS financial pressures. How are they affecting patient care?’

Understnading NHS financial pressures

Image source: https://www.kingsfund.org.uk/

Financial pressures on the NHS are severe and show no sign of easing. However, we know relatively little about their impact on patient care.

This study sought to investigate the impact of financial pressures in four very different areas of the health service: genito-urinary medicine (GUM), district nursing, elective hip replacement and neonatal services. The research used data analysis and interviews to explore different experiences across the system.

The researchers found that GUM and district nursing services were under particular strain. Both access to services and quality of patient care have been affected in ways that are difficult to detect with currently available metrics.

Within elective hip replacement services, activity has increased in recent years and patients remain happy with the outcome of their operations, but the latest data shows that average waiting times for treatment are starting to rise. Neonatal services appear to have largely maintained quality and access despite a number of longstanding pressures, although there is variation between units.

The findings create a challenge to the direction of travel set out in the NHS five year forward view of strengthening community-based services and focusing on prevention.

Read more here