One in four NHS trusts ‘expect to be in deficit’

17 Jul 14
A quarter of NHS finance directors expect to overspend their budgets this year, according to the King’s Fund’s latest quarterly monitoring report.

This is the highest proportion of finance directors expecting to be in deficit since the think-tank began its NHS monitoring work in 2011.

Today’s report warned that cracks were beginning to appear in NHS performance as a result of greater financial pressure and rising demand for services. Hospitals with major accident and emergency departments have now missed the A&E four-hour waiting time target for 51 weeks in a row, while more than 3 million people had been waiting at least 18 weeks for hospital treatment at the end of the quarter, the highest number since 2008.

John Appleby, chief economist at the King’s Fund, said: ‘Our latest quarterly report paints a picture of a service under huge pressure, with cracks beginning to appear in NHS performance.

‘It once again underlines the need for new funding if services are to be maintained.’

The report also highlighted what Appleby called a ‘worrying mismatch’ between activity and funding.

The King’s Fund found that 55% of clinical commissioning groups are planning to reduce emergency admissions, but less than 1 in 10 (8%) of NHS trust finance directors are working on that basis. Similarly, a third of CCGs are expecting an increase in elective treatment, compared to more than two thirds (69%) of finance directors.

Paul Briddock, director of policy at the Healthcare Financial Management Association said: ‘It comes as no surprise to hear from the King’s Fund that one in four trusts expect to overspend this year, as these results mirror the views outlined in HFMA’s NHS Financial Temperature Check... With resources continuing to be stretched, despite many NHS organisations just breaking even, we found that only 12% of provider trusts are confident in achieving their strict savings targets over the coming years.' 

He added that the sustainability of the NHS depended on the clinically led transformation of services, with support from both managers and finance staff.

'Our finance directors are certain that this transformation needs to happen faster than at present and we need to fully collaborate for this to happen effectively.’

Siva Anandaciva, head of analysis at the Foundation Trust Network, said: ‘Deficits are clearly increasing in the NHS provider sector and affecting trusts with good financial track records. Last year NHS trusts and foundation trusts reported over a £100m deficit and our members tell us this is likely to triple by the end of this year.

‘It is essential that the Better Care Fund planning process achieves its full potential by ensuring through genuine engagement with providers that lasting improvements to services are developed. It would be a missed opportunity to fall in to the trap of using the fund to focus plans on what capacity might be taken out of acute hospitals, rather than what capacity should be invested in community services to support new models of care.’


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