07.11.14
NAO warns financial pressures make NHS unsustainable
The government had to find more than £500m to prop up struggling health trusts this year, according to a report from the National Audit Office that found financial pressures were putting trusts at risk and making the NHS unsustainable.
In its annual report into the financial sustainability of NHS bodies the NAO found growing stress on NHS trusts and warned the situation was “not sustainable”. Thirty-one hospital trusts required extra money just to maintain services in 2013-14 – up from 14 the previous year.
Margaret Hodge MP, chair of the Commons public accounts committee, called the report “deeply alarming”.
“Things are getting worse rather than better and we all know that when trusts are under this kind of financial stress it is the quality and safety of patient care that can suffer. An increasing proportion of foundation trusts cannot meet the terms of their licence, including meeting key measures of quality and outcomes, and the NHS Trust Development Authority had concerns about more than half – 55 of 98 – NHS trusts,” she said.
“The Department, NHS England, Monitor and the NHS Trust Development Authority between them must explain to my Committee how they are going to get a grip on this wholly unsustainable situation and get our NHS back on track.”
The NAO report found that 22 NHS trusts were in deficit at the end of March this year compared to five the year before, with the number of foundation trusts in deficit more than doubling from 20 to 41. The gross deficit of NHS and foundation trusts has gone up by 150%, from £297.2m in 2012-13 to £743.3m in 2013-14.
It also warned that there was “considerable uncertainty” around government schemes, such as the Better Care Fund, aimed at reducing demand on acute hospital services.
Rob Webster, chief executive of the NHS Confederation, said that the report just confirms what is already known, that the NHS is under “incredible stress” and that the NHS has “reached a point where finances could collapse quickly”.
Chief executive of NHS England Simon Stevens said: "Week in week out NHS staff go the extra mile to ensure their patients get excellent care. But an aging population, a growing population and the possibilities of new treatments, all mean that pressures are real, and we need to get going on the new path set out in the NHS five-year forward view."
NHS England statistics for September show 3.2 million people on waiting list and 37,712 patients who waited longer than the 18-week target – the highest since the target was introduced in 2008.
At a board meeting of NHS England, Paul Baumann, chief finance officer, said: “This feels as if it is the year we are on the knife edge,” warning that the organisation “can't guarantee against any unexpected disasters” as winter approaches.
Amyas Morse, head of the NAO, said: “An increasing number of healthcare providers and commissioners are in financial difficulty. The growth trend for numbers of NHS trusts and foundation trusts in deficit is not sustainable. Until the Department can explain how it will work with bodies such as NHS England, Monitor and the NHS Trust Development Authority to address underlying financial pressures, quickly and without resorting to cash support, we cannot be confident that value for money will be achieved over the next five years.”
A Department of Health spokesperson said: "Financial discipline must be as important as safe care and good performance. Many NHS organisations are already achieving this and all understand the need for greater efficiency. Our reforms put power in the hands of local doctors and nurses to make decisions and control their own budgets to make sure patients receive the best services.”
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