NHS Finance

27.03.18

PAC: NHS finances ‘perilous’ as orgs focus on short-term fire fighting over long-term transformation

The Department of Health and Social Care’s (DHSC) lack of action to address the NHS’s finances is “disappointing,” according to the Public Accounts Committee (PAC).

The committee’s report, ‘Sustainability and transformation in the NHS,’ claims that the NHS is still in “survival mode,” and says that despite a £1.8bn rescue fund, its financial position remains “perilous.”

It argues that the department and NHS England are too focused on short-term balancing of the books and “propping up the system” and that they have not paid enough attention to the long-term improvement and transformation of patient services.

Trusts are forecasting a deficit of over £900m in 2017-18, and the committee says that there is still a long way to go before the NHS is financially sustainable.

The committee has repeated its previous warnings of the dangers of using short-term measures to balance the NHS budget, and criticised the department for not yet assessing the impact on patients or services of “repeatedly raiding its capital budget” to fund its short-term needs.

Local health bodies are setting up integrated care systems, which the committee says offers the potential for more strategic and long-term planning, as well as better joined up services for patients, but it has expressed concerns that witnesses have been unable to explain how accountability within these systems will work in practice, or how they will improve the care received by patients.

Meg Hillier, MP and chair of the committee, said: “We have said it before and we will say it again: rescue packages and budget transfers are no substitute for a coherent, properly funded strategy that enables NHS trusts to plan, focus on patient care and lay the groundwork for long-term financial sustainability.”

She called for a long-term plan for the NHS by July, and said that a funding settlement from the Treasury, that properly reflects the current and anticipated demand for NHS services, will be key.

Hillier added: “It remains unclear how local partnerships, set up to develop strategy and help to transform services, will be held to account for their performance. This must be addressed.

“Government should also move more quickly to identify successes in its piloting of new care models and ensure best practice is shared for the benefit of patients across the country.”

When asked about the rumoured injection of £4bn a year for the NHS yesterday, Simon Stevens, chief executive of NHS England, said that there will need to be a real terms funding growth trend, but declined to give an exact figure.

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