By Lucy Phillips | 4 August 2011
NHS foundation trusts in England are facing their most challenging period yet, regulator Monitor warns today.
The watchdog’s review of trusts’ annual plans for 2011/12 reveals significant pressures to find year-on-year savings, improve care standards and integrate large numbers of community services.
The plans, which have to include a three-year financial forecast and a one-year assessment of governance risk, show that the 138 trusts are seeking average efficiency savings of around 4.4% for 2011/12 and the next two years. Some 61% of these savings relate to staff costs.
At the same time, while income growth is forecast for 7.5% this year, it is expected to decline by around 1% for each of the following two years.
The number of trusts forecasting a high financial risk rating rose, up from 4 in 2010/11 to 11 this year.
Governance risk is also expected to increase, with the number of trusts forecasting low risk (‘green’) falling from 95 to 76 and the number predicting medium risk (‘amber-red’ or ‘amber-green’) rising from 31 to 57. However, high risk or ‘red’ forecasts fell from 12 to 5.
Monitor chair David Bennett said trusts intended to make savings through more efficient frontline working and reducing administration costs, rather than by treating fewer patients or reducing levels of care.
Bennett added: ‘We are very clear with foundation trusts that savings cannot be made by compromising on quality.
‘In my discussions with foundation trust leaders they are telling me that they anticipate the need for more radical service redesign, whether within their own organisations or across health economies. Where this is evidence-based and clinically appropriate, it can be an important way of delivering better quality patient care, for example, by moving services to newer facilities, and also achieving the objective of improving efficiency in the NHS.’
