NHS reforms

19.12.18

Blanket winter bans could happen again as DHSC accounts mask ‘underlying’ NHS deficit locally

Hospitals could face another winter of blanket operation cancellations and MPs have warned that “urgent action” is needed in the long-term plan as the finances of NHS providers are even worse than the reported statistics.

A report by the Public Accounts Committee (PAC) said MPs were concerned about the Department of Health and Social Care’s (DHSC’s) preparations for winter, and refused to rule out a repeat of the cancellation of non-urgent operations that occurred last winter.

The report said that despite the DHSC’s accounts for 2017-18 suggesting an improvement in fortunes, this masks the underlying deficits at a local level and the continued use of short-term fixes.

The figures state that 101 of 234 trusts ended the financial year in deficit and NHS Providers reported a total shortfall of almost £1bn, but the deficit figures are actually reportedly far worse and had to be largely offset by a surplus of £970m within NHS England’s finances.

NHS England achieved this surplus despite 75 of the 207 CCGs reporting an overspend this year – a whopping £213m collectively. MPs also said reports that a fifth of hospital trusts and health boards have missed A&E, cancer treatment and waiting-time targets “hammer home the concerns we hold” about local financial pressures.

The DHSC intends to ensure the finances are balanced at an individual CCG and provider level as part of its long-term plan for the NHS, but “this is some way off,” according to the committee.

Its report also criticised the department’s failure to assess the risk Brexit poses to the supply of medical equipment which “risks patient care,” and the “lack of a clear plan for recruiting staff after Brexit risks exacerbating existing staff shortages.”

Other issues highlighted by the PAC include failures by the department to forecast its exposure to clinical negligence costs and its lack of a robust fraud estimate.

As per the PAC’s recommendations, the DHSC must write to the committee by the end of January 2019 to outline how it will address these challenges.

Responding to the report, NHS Providers deputy CEO Saffron Cordery said: “Going into winter the pressures on the health and care system remain crystal clear. The NHS is entering its busiest time of year with record levels of demand for emergency care, severe workforce shortages and as this report shows a very difficult financial position.”

She argued that greater assurances from DHSC would be welcome to tackle the “daunting uncertainty” of Brexit, and that the report “rightly identifies the mismatch between the provider sector deficits offset against a surplus in NHS England’s budget.”

Image credit - George Clerk

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