Finance leaders in the NHS have set out a painful list of cost-cutting measures they are having to considerby Richard Murray / November 7, 2017 / Leave a comment
The NHS is now in its eighth year of austerity and it is no surprise that our latest Quarterly Monitoring Report finds it stuck in a Groundhog Day of deficits and slipping financial plans. The risks were always high that a continued malaise on finance would begin to damage patient care (rather than just the Chancellor’s fiscal forecast) and the evidence is that this is indeed happening. But where is the pressure on hospitals greatest? And what must be done to relieve it?
Our recent survey provides us with answers from multiple sources. 51 per cent of NHS trust finance directors and 59 per cent of clinical commissioning group (CCG) finance leads said patient care has worsened over the past year. CCG finance leads also set out a painful list of the measures they are having to consider in order to live within their budgets, with more than 80 per cent extending waiting lists, more than 60 per cent looking to stop funding for lower-value treatments and more than 50 per cent looking to use eligibility criteria (such as smoking or obesity) to reduce access.
Of course, at the same time waiting times in the NHS have continued to rise, whether in A&E or for planned care. The good news is that the rate of decline on A&E has been slowed to a snail’s pace, the bad news is that this was partly done by de-prioritising the 18-week referral-to-treatment standard for planned care. Despite waiting lists crossing the four million mark this year (and still rising), Trust finance directors now rate the 18-week standard much lower on their list of concerns—the de-prioritisation message has been heard loud and clear and is not encouraging for anyone waiting for treatment.
Unfortunately, although this was done to allow the NHS to focus on A&E, only 28 per cent of trust finance directors and 4 per cent of CCG finance leads think they will manage to meet the four-hour waiting time for A&E by March 2018 (the next milestone set by national NHS bodies). For many in the NHS “March 2018” seems like the distant future, given that to get to March you first have to get through the winter period.