NHS financial deficit twice the amount planned

NHS Improvement has published the year-end financial and performance figures for the NHS provider sector revealing a combined financial deficit that was nearly twice the amount planned.

The regulator showed that the provider sector finishes the year with a deficit of £960 million, which is £464 million more than was anticipated at the start of the year, with increased patient demand within the acute hospital sector responsible for much of the figure.

Given the amounting pressures facing the NHS, such a deficit is not at all surprising. But, as the Nuffield Trust think tank has argued, as finances have had to be patched up with one-off savings and emergency extra cash, the true underlying figure is likely to be much worse. NHS Improvement has reported that 156 of the 234 trusts finished the year either reaching or exceeding their financial targets.

Additionally, in its latest quarterly performance figures , the regulator claims that more than 5.87 million people went to A&E in January, February and March of this year, marking an increase of over 220,000 more than in 2017. However, performance against the four hour standard for 2017/18 fell to 88.4 per cent of patients compared to 89.1 per cent the year before. Nonetheless, over 2,600 people have waited more than a year for treatment and half of the nation’s ‘best performing’ accident and emergency departments are unable to meet waiting time standards.

Ian Dalton, chief executive of NHS Improvement, said: “Hundreds of thousands more patients have been to A&Es this year but the NHS did not buckle under the pressure. Despite epic challenges, NHS staff up and down the country displayed incredible resilience and saw more patients than ever before within four hours. More than two thirds of providers ended the year on budget or better than planned. Given rising demand and record vacancies, this is an important achievement.’

Chris Hopson, NHS Providers chief executive, said: “The figures reflect the worrying gap between what the NHS is being asked to deliver and the resources available following almost a decade of austerity. And we must remember that today’s figure masks the full underlying deficit which is much higher, and how reliant the NHS continues to be on one-off savings. These pressures are being felt by patients and staff right across health and social care. There are not enough staff, ambulances, community and mental health capacity or hospital beds to cope.

“This has become a year-round challenge, but the problems were compounded by severe winter conditions, with the result that too often, standards of care fell short of what trusts want to provide, and what the public has a right to expect. These pressures have had a substantial impact on trust finances. The additional A&E activity and the sharp rise in emergency admissions meant there was less income than expected from planned procedures such as knee and hip replacements. There were also extra staffing costs to cover increased vacancies, sickness and staff turnover. Today’s figures show a substantial part of any additional spending on the NHS in the future, will be spent on fixing the shortfalls that have built up in recent years.”

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