Providers call for end to ‘short-sighted’ £600m target breach fines

Around £600m will be withheld from NHS trusts this financial year as a result of fines imposed on them for failing to meet performance targets.

New analysis, published in the Guardian, shows that the fines are being imposed on hospital, community, mental health, and ambulance trusts, for missing targets.

For example, trusts that fail to reach the target of 95% of A&E patients being seen in four hours are fined £120 for each patient not treated within this time frame, and trusts that fail to reach the target of 92% of patients referred to non-urgent treatment within 18 weeks are fined £300 for each patient.

NHS trusts consistently struggle to meet targets, with only 10 out of 138 trusts achieving the A&E standard in January, and 179 out of 240 trusts are in deficit.

Chris Hopson, chief executive of NHS Providers, said: “NHS trust chief executives tell us they are intensely frustrated by these fines and see them as short-sighted, counter-productive and reflecting a sense of denial about how serious the problems facing hospital, community, mental health and ambulance services really are. They load yet more financial risk onto trusts at a time when the NHS is in the middle of the longest and deepest financial squeeze in its history and when trusts will end the year an unprecedented £2.8bn in the red.

“Trust chief executives tell us they are under enormous pressure – for example, the number of people coming to A&E in January 2016 was up 10% year on year and emergency admissions were up 5%. So it’s no surprise that many trusts are missing their performance targets.

“Imposing fines or refusing to pay the full cost of treatment makes no sense at all in this situation and does nothing to address the underlying reasons for trusts missing their performance targets.

“In fact, it makes things worse, because if a trust has to pay a fine, it can’t spend that money on extra staff and better patient care. Fines also just drive the provider sector further into the red just at the point when we are trying to return to finance balance.

“No one is arguing trusts should get a free pass – they should be accountable for how they perform – but fining them for circumstances largely beyond their control is counter-productive and leads to worse patient care and even bigger financial problems.”

The pressure on trusts has worsened after last year, when NHS England removed the ability of CCGs to waive fines and to reinvest fines in solving the problems that caused target breaches.

The Guardian said that £52.7m of Barts Health’s £79.6m deficit in 2014-15, at the time the largest overspend ever incurred by an NHS trust, were due to fines for missed targets.

An NHS England spokesperson said that they are suspending the penalties from next year and allocating £1.8bn to incentivise hospital performance improvement, but Hopson called for the suspension to be introduced immediately.

The NHS spokesperson also said: “For over a decade, well-established NHS practice has been that hospitals are incentivised to eliminate long waits for their patients, and rightly so. The successful result has been an enormous fall in typical long waits for an NHS operation – from over 18 months to well under 18 weeks.”




There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest news

View all News


NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental ... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Bei... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital exemplars who were revealed at the same show 12 months earlier.  Jeremy Hunt also stated that by the end of 2018 – the 70th birthday... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us throu more > more last word articles >


Mike Farrar, Swim England - Last Word

07/12/2019Mike Farrar, Swim England - Last Word

Mike Farrar Chairperson of Swim England Would you talk us through... more >

the scalpel's daily blog

Unappreciated Qualities of Leadership: Hope

17/02/2020Unappreciated Qualities of Leadership: Hope

Independent consultant and strategic advisor Dean Royles continues his series on The Unappreciated Qualities of Leadership. You can find links to his previous pieces here. ... more >
read more blog posts from 'the scalpel' >

healthcare events

events calendar


February 2020

mon tue wed thu fri sat sun
27 28 29 30 31 1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28 29 1
2 3 4 5 6 7 8

featured articles

View all News