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Leaders warn NHS cannot deliver on its 2017-18 commitments

Extra money for GP triage at A&Es is merely ‘marginal’

Adrian O'Dowd

Monday, 20 March 2017

NHS leaders are already warning that the NHS will not be able to deliver what is expected of it over the coming year without more support, even before the 2017-18 year has begun.

NHS Providers, the body that represents NHS organisations, has today published its Mission impossible? The task for NHS providers in 2017/18 report warning of the scale of problems faced by the health service.

The report presents a detailed assessment of the demands being placed on NHS trusts through NHS planning guidance compared against next year’s significantly lower funding increases and concludes that these expectations are well beyond reach unless greater realism, flexibility and support are given.

The report says the challenges facing the NHS in 2017-18 include:

  • absorbing a projected 3.1% increase in overall demand from patients and 2.1% increase in costs including pay, buildings and laboratories
  • recovering key performance targets, such as for A&E and routine operations – the estimated extra cost of delivering these targets across the year is £2.4 bn–3.1bn
  • delivering new commitments on cancer and mental health with an estimated cost of £150m-£200m
  • trusts collectively balancing their books with an estimated financial performance improvement of £800m-£900m required.

The report says: “The 2017 budget announcements of £2 billion for extra social care, £100 million capital for extra GP front door triage in A&E departments and £325 million capital for the most advanced sustainability and transformation plan (STP) footprints were welcome.

“However, they are unlikely to make a significant difference to this underlying position. The impact of extra social care support on NHS performance in 2017/18 is uncertain given that there are no ‘must benefit the NHS conditions’ attached to the new funding. Extra capital of £425 million is marginal in the context of an estimated £2.4 billion a year required for STPs and a forecast maintenance backlog of £5.8 billion.”

The authors said there were possible ways of making what is expected of trusts more deliverable such as:

  • NHS leaders setting more realistic performance trajectories against the key targets
  • building on work already started to review whether more of the £5 billion currently spent on commissioning and the Department of Health and its arms-length bodies can be redirected to front line care
  • providing more support to NHS trusts to enable them to improve performance and eliminate unwarranted variation more rapidly.

NHS Providers chief executive Chris Hopson, said: “The NHS is a can-do organisation which achieves extraordinary results for patients every day. NHS trusts are treating more patients than ever before and performance remains good by international standards. So when those trusts say that they can’t deliver what’s currently being asked for next year, it is time to sit up and listen.

“It is unprecedented for us to warn the NHS will not be able to deliver on its commitments before the financial year has even started.

“But trusts are currently being asked to absorb a 5% plus cost and demand increase, recover the four A&E wait and 18-week surgery targets, improve care for cancer and mental health and balance next year’s books financially. All on a 1.3% funding NHS England funding increase, down from this year’s 3.6% increase. Taken together, this is mission impossible. The numbers don’t add up.”

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