Looking ahead: the NHS at 100 | Healthcare Financial Management Association
The challenges facing the NHS are significant. Waiting lists are increasing, A&E attendances are rising and access to GP
appointments can be difficult. Alongside this is a growing population who are living longer and developing more complex conditions, which increases demand on an
already overstretched service.
This report explores the key challenges the HFMA think will have the biggest impact on the financial future of health and social care. It highlights the likely direction of travel and provides insight to help inform current decision-making.
The King’s Fund | May 2018 | Spending on and availability of health care resources: how does the UK compare to other countries?
The King’s Fund has published a briefing which analyses UK spending on health care compared to other European countries. The briefing focuses on a small number of key resources – staff, beds, equipment and medicines – using data from the Organisation for Economic Co-operation and Development (OECD). The think-tank has also updated their analysis of how much the UK spends on health care under the new System of Health Accounts 2011 methodology, which has led to substantial changes in what is classed as ‘health care spending’ (The King’s Fund).
The key messages include:
Our analysis of health care spending in 21 countries shows that the UK has fewer doctors and nurses per head of population than almost all the other countries we looked at. Only Poland has fewer of both.
The UK has fewer magnetic resonance imaging (MRI) and computed tomography (CT) scanners in relation to its population than any of the countries we analysed. Although this data should be treated with particular caution, it is clear that the UK lags a long way behind other high-performing health systems in investing in these important technologies.
Of the countries we looked at, only Denmark and Sweden have fewer hospital beds per head of population than the UK, while the UK also has fewer beds in residential care settings than comparator countries. While lower numbers of hospital beds can be a sign of efficiency, the growing shortage of beds in UK hospitals indicates that bed reductions in the NHS may have gone too far.
Although costs are rising, the UK spends less on medicines than most of the countries we analysed. A key reason for this is the success of initiatives to improve the value of expenditure on medicines, such as encouraging the use of generic drugs.
The other key messages are available from The King’s Fund
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.
“The Budget on 22 November 2017 contained some obvious good news for the NHS: it provided more money, if not as much as we hoped. With more money comes the inevitable re-set of NHS plans and the new planning guidance came out on 2 February.
This is desperately late in the day given the new financial year starts on 1 April but was inevitable given the financial settlement for the NHS changed so significantly at the last minute,” writes Richard Murray, Director of Policy at the King’s Fund.
You can read Murray’s full piece about what the guidance didn’t say, and also provides a commentary on some of the key changes around money, performance and reform
Pay restrictions meant £2.6 billion less for NHS staff last year | Nuffield Trust
With the NHS in England in recent years on a savings drive, this comment from Mark Dayan of The Nuffield Trust asks how much staff have contributed through freezes and caps on their pay packets. But the question is a tricky one. To answer, we need to be able to compare what has actually happened to pay with what would have happened if the NHS hadn’t been trying to make any savings. This data blog explores further and puts a figure on it.
This briefing assesses the financial health of those providers by unpicking the headline figures presented in the official accounts to reveal the true underlying state of the NHS’s finances today, and to outline prospects for the next three to four years | Nuffield Trust
NHS trusts have begun the current financial year, 2017/18, on course for an underlying overspend or deficit of £5.9 billion. To meet their reported deficit target of £500 million, they will need to cut their operating costs by £3.6 billion and receive temporary extra funds of £1.8 billion.
This would require trusts to make savings in one year equivalent to 4.3 per cent of their operating costs – far in excess of any level achieved over recent years and likely to be almost impossible to deliver.
A more likely scenario is that they will make cost savings similar to the level made last year. That would collectively leave the trusts with an underlying deficit of around £3.5 billion.
The headline deficit for 2016/17 (which ended in March 2017) was £791 million. However, that figure was flattered by billions of pounds’ worth of one-off savings, temporary extra funding and accountancy changes that did nothing to improve the underlying state of provider finances. Once they are removed, the underlying deficit for 2016/17 is £3.7 billion.
This is compared to an underlying deficit the year before, 2015/16, of £4.3 billion. As trusts also had to soak up additional inflation costs in 2016/17, the reduction in the underlying deficit between 2015/16 and 2016/17 actually represents providers making £2.3 billion in permanent savings.
Projections of future years suggest that, even under optimistic assumptions for inflation and continued high levels of savings, NHS providers will continue to run a large collective underlying deficit until at least 2020/21.
Guidance for NHS bodies on the acceptance, management and transfer of charitable funds | Department of Health
This guidance gives an introduction to the general principles determining the financial responsibilities of trustees of NHS charities. It outlines how funds held on trust are handled and managed, including the processes for transferring funds to other bodies.