18.11.16
NHS racks up £648m deficit in Q2 as ‘window for transformation’ shrinks
NHS trusts and FTs are beginning to recover financially, with fewer providers reporting a deficit for the second consecutive quarter, NHS Improvement (NHSI) figures released today revealed – but the provider sector’s year-to-date deficit nevertheless stood at £648m.
A total of 142 trusts reported a year-to-date deficit at the end of Q2 in 2016-17, 11 fewer than in the first quarter and 40 fewer than the same time last year. To date this year, providers have reduced their total expenditure by 2.9%, making £1.2bn of savings through cost improvement programmes.
But despite efforts, the year-to-date deficit was still £22m worse than had been predicted.
However, NHSI argued that this deficit can be lowered to £580m if providers meet their end-of-year targets.
Jim Mackey, the regulator’s chief executive, was optimistic about the figures, saying: “No-one should underestimate the challenge of turning around a very difficult financial position for the NHS. But, thanks to a phenomenal effort by staff across the NHS, we’re 1-nil up at half time.
“We can’t allow ourselves to be complacent. We know that we’ve got a lot of hard work still to do, and we’ll need each and every person within the NHS to play their part. We owe it to the people who use and fund our services to provide the best quality care possible within budget.”
Today’s figures come as NHS providers continue to clamp down on excessive agency spending, which NHSI argues is unaffordable and offers a bad deal for patients and permanent staff. They hope to save £900m this year due to new agency controls.
However, the regulator has emphasised that there is still work to be done as it aims to launch further initiatives to support the remaining trusts and certain specialties, such as radiology, which are not pulling their weight.
Hopes for Autumn Statement
NHS services are currently facing unprecedented growth in demand, with a 4.1% year-on-year rise in A&E admissions and 34.8% increase in bed days lost due to delayed transfers of care, compared to halfway through last year.
Ambulance services have also been affected, with a 9.9% rise in calls deemed to be “time-critical”, and a 14.1% rise in “life-threatening” calls, causing services to miss key response targets. The waiting list for emergency inpatient care has now reached a record high of 3.51 million.
NHS services are currently facing unprecedented growth in demand, with a 4.1% year-on-year rise in A&E admissions and 34.8% increase in bed days lost due to delayed transfers of care, compared to halfway through last year.
Ambulance services have also been affected, with a 9.9% rise in calls deemed to be “time-critical”, and a 14.1% rise in “life-threatening” calls, causing services to miss key response targets. The waiting list for emergency inpatient care has now reached a record high of 3.51 million.
Richard Murray, director of policy for The King’s Fund, said that the increase in delayed transfers showed the impact of cuts on social care budgets and highlighted the need for the chancellor Phillip Hammond to address the “critical state” of social care in his forthcoming Autumn Statement.
“With an increasingly threadbare system taking an unacceptable toll on older people, their families and carers, finding more money for social care is an early test of the prime minister’s commitment to a more equal country that works for everyone,” Murray said.
Murray noted that while a year to date deficit of £648m represents good progress being made by NHS trusts compared to this time last year, the second half of year is likely to prove more challenging if trusts miss their financial and efficiency targets.
Anita Charlesworth, director of research & economics at the Health Foundation, expressed doubts that trusts will not breach their end of year deficit targets, stating that even if planned increases in funding are brought forward, NHS trusts will have a “mountain to climb”.
“The plan to reduce the deficit and improve performance against key waiting time targets over the second half of the year is highly ambitious,” she said. “In previous years debts and waiting times have increased in this period as trusts deal with the increased pressures of winter.”
“Despite the agency cap, spending on temporary staff is 16% higher than planned, suggesting that the lack of a workforce strategy is still hitting trust finances.”
Stephen Dalton, chief executive of NHS Confederation, agreed that the recent strain on the NHS is a knock-on effect of ongoing government budget cuts, and followed Murray in urging the chancellor to back NHS services and social care.
“These figures show further progress in repairing large holes in the NHS budget, but the NHS continues to be stretched to the limit with additional pressure caused by ongoing cuts to social care, mental health and public health,” Dalton said in response to the Q2 figures.
“The window for transformation gets smaller by the day and it’s crucial the upcoming Autumn Spending Review looks to reduce pressure on the NHS to enable it to deliver change. Relying on a political rhetoric that promises to protect the NHS, but fails to acknowledge that a cut in social care results in a cost to the NHS, is an economic deception.
“We also need to remember the human story behind these figures. NHS staff are working under enormous pressure and it's their daily commitment that is keeping our NHS safe and delivering great care.”
Despite the pressures facing services, NHSI’s figures show that A&E departments have coped well in the last quarter, successfully treating, admitting or discharged 89.74% of patients that attended within four hours – an improvement on last year’s figure.