How much has the NHS saved by holding down pay?

Pay restrictions meant £2.6 billion less for NHS staff last year | Nuffield Trust

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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.

Read the full blog post here

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What does the Autumn Budget mean for the NHS and social care?

In the budget this week, the Chancellor committed around £2 billion extra for the NHS next year. Nigel Edwards of the Nuffield Trust said this will bring respite for patients and staff, but is only around half of what’s needed.

In a Q&A about the budget, Tom Moberly, The BMJ’s UK editor, met with John Appleby (Nuffield Trust), Anita Charlesworth (Health Foundation) and Siva Anandaciva (King’s Fund) to discuss what it all means for the NHS and social care. You can watch the discussion below:

£4 billion needed next year to stop NHS care deteriorating

Analysis from the Health Foundation, The King’s Fund and the Nuffield Trust suggests the government must find at least £4 billion more for the NHS in the Budget to stop patient care deteriorating next year.

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The briefing calls on the government to recognise the immediate funding pressures facing the sector in 2018/19, which will see NHS funding growth fall to its lowest level in this parliament.

The publication also urges the government to act to close the growing funding gaps facing the health and care system, which it says are now having a clear impact on access to care.

The report calls for a credible medium-term strategy to better match the resources for the health and care service with the demands it faces, and proposes a new independent body to be established to identify the long-term health care needs of the population and the staffing and funding required to meet these needs.

Full briefing: The Autumn Budget:  Joint statement on health and social care

Related press release from The Health Foundation

Understanding the NHS deficit and why it won’t go away

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

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Image source: 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.

Read the full briefing here

NHS funding and privatisation: the facts

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A lecture and article by the scientist Professor Stephen Hawking outlining his views on the NHS have prompted a lively debate about a number of issues.

Here the Kings Fund looks at the facts about two of these: whether the NHS is being privatised and if it has been given the funding it needs:

Is the NHS being privatised?
The involvement of the private sector in the NHS is a hotly contested topic. Private companies have always played a role in the NHS, but critics claim that their increasing involvement is evidence of growing privatisation of care and is undermining the service’s core values.

Does the NHS need more money?
In recent years, spending on the NHS has been protected while other budgets, such as those for local government services and policing, have been subject to significant cuts. Despite this, health services are facing unprecedented financial and operational pressures, with many NHS organisations in deficit and key performance standards being missed.

Investment in NHS transformation projects

Secretary of State for Health and NHS England have announced £325m of capital investment for local projects that will help the NHS to modernise and transform care for patients.

Patients will see this investment deliver faster diagnosis for conditions like cancer, easier access to mental health care, expansion of A&Es, shorter waits for operations, and more services in GPs surgeries. This initial tranche of funding has been targeted at the strongest and most advanced schemes in STPs.

Read more via NHS England

Additional link: RCGP press release

Department of Health annual report

The annual report and accounts show how the department has funded its activities and used its resources in the period 2016 to 2017. | Department of Health

The annual report and accounts give an overview of the department’s resources and how it has used them to fulfill its statutory functions during the financial year 2016 to 2017.

The document describes DH’s performance against objectives and includes the Secretary of State’s annual report on the performance of the health service in England.

Department of Health annual report and accounts 2016 to 2017 (web version)

Department of Health annual report and accounts 2016 to 2017 (print version)

Additional link: Health Foundation press release