24.06.14
NHS finance directors ‘not confident’ of achieving targets
Only 12% of trust finance directors are ‘quite or very confident’ of achieving their financial targets in 2015-16, a new Healthcare Financial Management Association (HFMA) study has found.
The survey of 188 finance directors revealed that of the 88% that were ‘not confident’ of delivering the targets, more than two-fifths felt it was too early to say and 44% were not very or not at all confident.
The NHS Financial Temperature Check research also shows the number of organisations overspending or reporting a deficit has increased since the 2012-13 financial year and more organisations are reporting an actual deficit than planned to at the beginning of this financial year.
In the last financial year, clinical commissioning groups (CCGs) and provider trusts delivered planned financial savings of 2.3% and 4.5% respectively, but this was not the case across the board and fell short of the overall planned savings (2.5% and 4.8% respectively).
However, more than one-third (39%) of NHS finance directors expect the quality of services in the NHS to improve over the next few years and over half (53%) expect quality to hold steady in the same time period. This is despite concerns from financial regulator Monitor that the NHS faces a £30bn funding gap to 2021.
According to the HFMA report, for provider trusts, the top two cost pressures were the costs of increasing demand for services and the costs of increasing numbers of nursing staff. Commissioners named three cost pressures as being particularly significant: emergency care, continuing healthcare and increasing demand.
Respondents added that in an effort to deal with the cost pressures and future financial challenges, trusts plan to redesign jobs to reduce the cost of staff numbers as well as reducing clinical variation and integrating community, mental health and acute services.
Paul Briddock, director of policy at the HFMA, said: “Resources are being stretched and although many NHS organisations have just got by, we have seen an increasing number of them report a deficit last year.
“We are seeing financial problems materialise in organisations that have previously been financially stable. If all things stay equal, the financial outlook looks increasingly challenging, but despite this, it is encouraging to see that finance directors do not see quality deteriorating – in fact, many think quality will improve. “
The report, however, highlighted that there was some concern about the impact of the implementation of the Better Care Fund, which comes into operation from 1 April 2015. While supporting the move to integrate services, only 2% of provider trust finance directors and 11% of CCG chief finance officers think that the Fund will help improve their organisation’s services for patients and users in the first year. This rose to 25% and 62% respectively after the first three years.
Professor John Appleby, chief economist at the King's Fund, said: “This report echoes our own surveys and highlights a truth now widely acknowledged within the NHS – that it is heading towards a financial crisis in 2015-16, if not before.”
But the Department of Health said it expected the NHS to live within its means. “We've taken tough decisions to protect the NHS budget and the system is on track to make £20bn savings this parliament to reinvest into frontline care. We are confident that the NHS will continue to make the savings necessary to meet rising demand,” said a spokesman.
“Trust chief executives need to have a tight financial grip to keep delivering high quality services whilst making the savings necessary to meet rising demand.”
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