Stevens: FYFV update due in spring as NHS faces ‘very real’ pressures

NHS England chief executive Simon Stevens has said that the NHS faces “very real” pressures that are only likely to become more trying as funding becomes more “constrained” over the next three years, saying that the NHS got “less [money] than it asked for” from the government.

Stevens made his comments under questioning by the Public Accounts Committee (PAC) on the financial sustainability of the NHS alongside Jim Mackey, the chief executive of NHS Improvement, and two representatives from the DH, David Williams and Chris Wormald.

Stevens said that the NHS was “fortunate” to get front-loaded funding increases this year after Meg Hillier, chair of the PAC, picked up on comments made by NHS Providers leader Chris Hopson that the NHS can no longer deliver what is being asked of it under its current financial pressures.

“We heard from Mr Hopson very clearly that there’s not enough money in the system and the NHS can no longer deliver what’s being asked of it, but the government is repeatedly telling us that the NHS is getting more money than it asks for. What is your view?” Hillier asked.

“It’s right that by 2020 NHS England will be getting an extra £10bn over the course of six years. I don’t think that’s the same as saying we’re getting more than we asked for over five years as it’s the Five Year Forward View, not six years,” Stevens replied.

“I said to the Select Committee back in October that like probably every part of the public service we got less than we asked for in that process, so I think it would be stretching it to say that we got more than we asked for.”

He added that NHS England will look to refresh its Five Year Forward View considering what needs to be done in the NHS over the next two years, with the update to be produced by the end of March.

Stevens faced questioning as NHS services find themselves in the midst of unprecedented demand. NHS Digital reported higher numbers of people visiting A&E than ever before at over 20 million attendances last year, leaving hospitals facing pressures which Stevens said with surprising candour were “legitimate and real … and therefore they need to be funded”.

Tensions have been exacerbated by the health secretary Jeremy Hunt who this week proposed a controversial change to hospitals’ target to treat and admit or discharge those who attend within four hours so that it only applies to patients with ‘urgent’ health problems.

Hillier questioned the motives of Hunt’s comments while hospitals are reporting their worst levels of performance against the target since its introduction, asking: “Are there any plans to drop targets or extend waiting times?”

Wormald, DH’s permanent secretary, stressed that “the government [is] committed to maintaining that vital four-hour commitment to patients,” but said that Hunt was right in suggesting that “we need to have a conversation about how A&E is used for the patients that A&E is designed for”.

Mackey added that bodies would be meeting with the Royal College of Emergency Medicine today (12 January) regarding the four-hour standard, explaining that circumstances have changed since its introduction.

“The 95% standard is still a really important indicator of system health [but] there’s an awful lot of people in there who could be seen in another setting,” Mackey said. “What I’m bothered about is that … departments are able to un-crowd themselves so clinicians can focus on the sickest patients.”

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