19.11.14
Expanding workforce is driving the FT sector deficit – Hopson
Growing patient demand and a shortage of funding to plug the skills gap are two of the main reasons why the foundation trust sector is “collectively in deficit for the first time ever”, according to Chris Hopson, chief executive of the Foundation Trust Network (FTN).
Speaking at the opening of the organisation’s annual conference yesterday, he said: “We’re grappling with a centrally mandated and immediately required increase in the size of the workforce, which – wholly unsurprisingly – is creating a massive recruitment and financial headache for nearly every trust that I visit.
“The money simply hasn’t followed the demand of staff needs, so providers have had to absorb an extra £1.2bn on the wage bill at exactly the point of the end of this Parliament when the financial pressure has been at its greatest.
“There is no wonder that the foundation trust sector is collectively in deficit for the first time ever, and more than 60% of acute trusts were in deficit at Q1.”
Hopson, who also unveiled a name change for the FTN, which will become NHS Providers, the association of foundation trusts and trusts, from 1 December, was also critical of the current regulatory landscape.
The rebranding of FTN has been done to highlight that the organisation, which represents over 94% of NHS acute, mental health, community and ambulance services, is the single voice for all those members – not just foundation trusts.
But Hopson stated that the NHS has a provider sector whose “defining characteristic is rapidly becoming its fragility” as it is consistently run “hotter and hotter at capacity levels that our continental cousins would never contemplate”.
“We have a system where the margins between apparent success and failure are wafer-thin and where a small gust of wind, like a local nursing home closing due to a poor CQC inspection report, can make the difference between meeting a performance target or not,” he said.
“There is a fragmented and increasingly interventionist regulatory regime that seems to be taking us back to centrally-driven micro-management that this government promised it would abandon four years ago, and an NHS system culture that seems all too willing to point the finger and all too unwilling to provide the support when providers cross that wafer-thin margin by missing a target and recording an outlier mortality rate or getting a poor waiting list CQC inspection.”
On a positive note, though, Hopson stated that there is a “rapidly rising recognition” that trying to run harder in the existing model simply won’t work anymore.
He highlighted that the Five Year Forward View points out that the NHS has to transform and there is a remarkable degree of consensus on what that should look like. For example, getting serious about prevention; empowering patients to manage their own health and long-term conditions; and moving to new ways of delivering care – eliminating the artificial boundaries between primary and secondary care.
During his keynote speech he also launched the organisation’s ‘Programme for the Next Parliament’ document, which sets out what action it would like to see the next government take following the 2015 general election.
Dame Gill Morgan, chair NHS Providers, outlines this further in the November/December issue of NHE. To read more about this year’s FTN conference, full coverage will be in the January/February edition.
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