By Richard Johnstone | 25 April 2014
Nearly £1.2bn will be spent across the NHS to improve patient care following the public inquiry into failures at the Mid Staffordshire hospital trust, a survey has found. But the poll of NHS hospital trusts and foundation trusts by the Foundation Trust Network warned the extra costs were likely to push some into deficit for the first time.
According to the survey of 50 foundation trusts or aspirant trusts, £712m had been earmarked for care improvements in 2014/15 to implement the recommendations of the Francis report into care failings at Mid Staffs. This follows £450m spent in the previous financial year.
At least 90% of this investment is being spent on extra staff, particularly nurses and also comes in response to the new inspection regime introduced by the Care Quality Commission watchdog, the poll found.
Foundation Trust Network chief executive Chris Hopson said the spending would improve care, but warned some hospitals would run deficits for the first time, as the cost of improvements were not being fully met by government.
For example, a £150m increase in the NHS payment tariffs paid to acute trusts in 2014/15, known as the service development uplift, only covered around a quarter of the actual cost of the improvements being made.
According to the poll, 100% of the acute trusts surveyed were either not confident or unsure whether these costs would eventually be covered by the tariff or local agreement with commissioners. This was also the view of 80% of non-acute trusts.
Further costs were being incurred as a result of the government’s NHS Mandate, which sets out planned health service improvements, such as introducing seven-day services and moving to integrated care models.
These unfunded spending increases were taking a toll on hospital trusts, Hopson stated.
‘Our members tell us that they are being asked to absorb rising demand; realise annual efficiencies at a level no other Western health economy has ever consistently achieved; potentially take a further £2bn out of NHS acute care for the Better Care Fund in 2015/16; and, now, pay for a range of mandated new service improvements themselves on top of all this,’ he said.
‘This will require difficult choices. For some, it will mean going into deficit for the first time.’
He called for the Department of Health to adopt a different approach to paying for service improvements in response to the squeeze, including full funding any changes included in the mandate. Higher costs as a direct result of the Francis report should also be reflected in either future service development uplifts or higher tariff prices, and there should also be clear, realistic and detailed plans to realise any projected efficiencies.
