AN URGENT cash injection of £8bn is needed within the next 18 months if the NHS is to meet its commitments to the nation, the Healthcare Financial Management Association (HFMA).
The body – which represents NHS finance directors – says the vast majority of its members have lost confidence that the plan set out in the Five-Year Forward View is achievable.
Some 84% of finance directors say they lack the sufficient financial resources to implement the plan without extra support and 88% don’t have the confidence that their organisation can deliver the 2% to 3% a year ‘productivity gains’ needed to close the expected £22bn NHS funding gap.
The new figures emerge from the HFMA’s latest biannual NHS Financial Temperature Check survey of over 200 finance directors in England. It reveals that while FDs welcome the efforts of Lord Carter’s £5bn NHS savings plan, they are sceptical that the savings can be made. And when asked if the new care models outlined within the five-year forward view and piloted at Vanguard sites can deliver the financial benefits required to meet the remaining £17bn NHS funding gap, 57% say no and 42% are uncertain.
FDs are also questioning whether the promised £8bn of additional government funding will be sufficient. Some 43% don’t think the NHS can continue to deliver the current levels of quality within the levels of increased funding currently promised and a further 56% say quality can only be maintained if the £8bn funding is frontloaded. Almost all (94%) feel the £8bn already pledged is needed no later than the next 18 months.
Their concerns come as financial projections continue to deteriorate, with 100% of acute trusts responding to the survey predicting a year-end deficit, compared to 77% four months ago, and 66% of all trusts (including non-acute trusts) forecasting a 2015/16 deficit, up from 63% in the HFMA’s last report.
Paul Briddock, director of policy at HFMA, said: “Our report confirms the financial problems in the NHS are systemic and across the board, with particular and immense pressure being felt on the acute provider side. The scale of deficit reported is unprecedented.
“With just days left before the Spending Review, finance directors are telling us they’re not confident in the current plans and need more clarity. While they’re not convinced the promised £8bn in funding is sufficient to address the whole financial problem, it’s clear it is needed now and many want to know if it will come with conditions attached to it. Providers also need realistic efficiency targets with adequate funding for the new demands and cost pressures facing them. Today’s report tells us it’s time to think about what Plan B is, if all else fails.”
While 39% of finance directors report that there is a high degree of risk to achieving their financial plans for 2015/16, this figure leaps to 71% when finance directors look at 2016/17. Only 5% of trust finance directors expect to deliver their 2015/16 savings target recurrently, placing more pressure on budgets year on year.
The biggest risks to trusts achieving planned savings were cited as slippage in cost savings (82%), agency staff costs (66%), impacts of social care financial constraints (56%), impact of delayed discharges (56%) and increasing demand (54%).
Despite widespread pessimism about the financial position this year, 88% of finance directors do not expect the quality of patient services to reduce in 2015/16.
However, there are concerns that it could deteriorate next year, with the proportion believing it won’t get worse in 2016/17 falling to 68%. Waiting times (74%) and access to services (63%) were deemed to be the most vulnerable areas.
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