Providers must work at 'pace and scale' to tackle deficits and target failures

NHS providers need to do more work “at pace and scale” to tackle their growing deficits and performance target failures, NHS Improvement has stated.

Monitor’s financial figures for the latest quarter reveal that the NHS made £741m efficiency savings in April to December 2015, but still had a £2.3bn deficit. They also show that 179 out of 240 NHS providers are reporting a deficit, of whom 132 are acute trusts.

There were also problems with performance, with the NHS only seeing 90.7% of A&E patients within four hours, significantly below the 95% target. NHS providers also spent £2.72bn on agency and contract staff, £1bn more than planned.

Jim Mackey, chief executive designate of NHS Improvement, said: “This performance will be very disappointing for providers, and shows the range of difficulties they’re facing. 

“Despite this, providers are making progress on improving their finances whilst also providing more treatment, to more patients with more complex care needs than ever before. However, further improvements will be required by the whole NHS at pace and scale to tackle the current financial and operational challenges it faces.”

NHS Improvement reported on Tuesday that NHS spending on agency staff is increasing because of staff shortages.

In other performance measures, 2.2% of diagnostic tests waited more than six weeks, above the 1% target. The NHS generally surpassed targets on cancer referrals – for example, 97.9% of patients had a 31 day or less wait from diagnosis to first treatment, compared to a 96% target.

However, 83.5% of GP referrals for cancer took more than 62 days, beneath the 85% target.

Category A ambulance calls took 19 minutes or less to arrive in 92.7% of cases, with a target of 95%.

Saffron Cordery, director of policy and strategy at NHS Providers, and a member of NHE’s editorial board, said: “Today’s performance reports reflect the rapidly deteriorating financial position that providers have been flagging for some time now.

“NHS providers are doing all they can to avoid financial deficits but with the majority expecting to be in deficit by the end of 2015-16 shows that this is a system level problem, not one of poor trust performance. The combination of rising demand especially for urgent and emergency care and addressing systemic issues such as delayed transfers of care mean there are sustained financial and operational pressures on providers.

“NHS providers have made every effort to make efficiencies including early savings through the adoption of the agency staff spending cap and a cap on management consultancy spend. These measures have the potential to deliver further savings and be a key part of tackling the deficit. The support that Monitor and the TDA have given to individual trusts to implement the new rules is welcome but their full benefit will take time to realise.”

Dr Steve Kell, the outgoing NHS Clinical Commissioners co-chair and chair of NHS Bassetlaw CGC, said providers across England are already working with significant deficits, and the commissioning sector is not far behind as CCGs are likely to struggle to reach a balanced financial position this year.

“On the face of it some might say the NHS did well in the Spending Review settlement, but the headline growth figures actually hide a lot of things that have already been committed leaving the whole system with very little new money to invest,” he said. “The collective challenge now is how do we stabilise the system in the short term without sacrificing the long term sustainability of the NHS. Transforming services is the key, we cannot keep ploughing money into doing more of the same.”

Cambridgeshire and Peterborough CGC, for example, has a £14.8m deficit following the collapse of its contract with UnitingCare.

The full Monitor report is available to view here.




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