An extra £1.8bn allocated for 2016-17 has not allowed the service to shape itself to survive on significantly less funding growth from 2017-18 onwards as intended, the auditor's report on sustainability and transformation in the NHS out today noted.
This comes on the same day CIPFA has released its submission to the Health Committee’s inquiry into Sustainability and Transformation Plans, saying financial pressures on the NHS and local government were hampering STPs in achieving their goals.
STPs – partnerships between local authorities and the NHS to improve health and care services - are considered to be vital in improving the NHS service over the next few years.
The NAO report found STPs in too many cases relied on “over optimistic” plans and the NHS had mistakenly chosen to focus attention on the most advanced partnerships rather than the weakest.
It also concluded they were being “hampered by a lack of resources and ongoing pressure to make increasingly tighter finances balance each year”.
Progress had been made in setting up the 44 new sustainability and transformation partnerships since they were formed in March 2016 but “many still have a lot to do to establish effective governance arrangements and realise their plans”, the report concluded.
NHS investment for transformation was concentrated on partnerships that were most advanced, “which risks those that are relatively under-developed or complex being left further behind”, the NAO noted.
It added that most of the 44 partnerships’ plans were “overly optimistic, relying on transforming services to move more care out of hospital and into the community.”
Clinical commissioning groups and trusts were increasingly reliant on one-off rather than recurrent savings measures, auditors found.
Between 2014-15 and 2016-17, the percentage of non-recurrent savings increased from 14% to 17% for commissioners, and from 14% to 22% for trusts.
“This poses a significant risk to the financial sustainability of the NHS in the future,” the report said.
NAO head Amyas Morse said: “The NHS has received extra funding, but this has mostly been used to cope with current pressures and has not provided the stable platform intended from which to transform services.”
Today’s report suggested the Department of Health & Social Care, NHS England and NHS Improvement “move further and faster towards system-wide incentives and regulation”, as many of these were still assessed on an obsolete institution-by-institution basis.
CIPFA chief executive Rob Whiteman said: “STPs are our best shot at making meaningful and lasting improvements to health and social care services.
“And across the country, many STPs are making a promising start.
“To ensure STPs can reach their full potential, it is important that they are supported by a greater level of resources and that their plans are realistic.”
He added: “Otherwise, the transformation agenda will be jeopardised and services will continue to be at risk.”
Labour MP Meg Hillier, chair of the Public Accounts Committee, said: “The Department of Health’s recent cash injections have been spent on patching up the problems, not preparing it for the future.”
The Department of Health & Social Care said the NHS had “made significant progress towards balancing the books and returning to a financially stable position”.
She added STPs were being backed as part of £3.5bn of capital funding announced in the recent Budget.
