NHS spending plans delayed because of financial pressures

The King’s Fund has revealed NHS spending across a number of areas is expected to be cancelled or delayed due to money difficulties

The latest quarterly monitoring report from The King’s Fund suggests NHS spending could be put on hold across half of local areas.

Fifty per cent of clinical commissioning group (CCG) finance leads admitted achieving financial forecasts for the year relied on delaying or cancelling spending.  Around 40 per cent said they plan to review or reduce the level of planned treatment they commission in response to the downgrading of the 18-week referral to treatment target. Concerns were also raised about the ability to increase funding for mental health services, with just under half of CCGs uncertain they would meet national commitments.

Difficulties ahead

While more than half of trust finance directors have revealed they expect to end the 2016/17 financial year in surplus, the outlook still remains gloomy. Trusts relied on gaining finance from one off sales such as land and payments from the Sustainability and Transformation Fund to improve the books. However, the financial year ahead looks difficult, with 43 per cent of finance directors expecting to overspend their budget and 46 per cent concerned about meeting targets. Only one in five CCG finance leads are confident they can achieve a financial balance.

The report did reveal some good news, with the final quarter of 2016/17 seeing a vast improvement in the performance of A&E departments. Ninety per cent of patients were admitted, transferred or discharged within four hours. Still, finance directors remain cautious, with nine per cent not confident the NHS will meet this target again by September 2017. Furthermore, despite improving performance in A&E, 2.5 million patients still spent more than four hours waiting. This was an increase of over 685,000 when compared to the year before.

The report also revealed 362,000 patients waited more than 18 weeks for hospital treatment in March 2017—an increase of 64,000 on the same period the year before. Furthermore, 26,283 cancer patients waited more than 62 days for urgent treatment, up eight per cent on the year before.

Tough decisions ahead

Richard Murray, Director of Policy for The King’s Fund, said: “Given the enormous pressures experienced in January, the improvement in A&E performance in February and March is a tribute to successful planning and the hard work of NHS staff during a difficult winter.

“While the financial picture improved at the end of the last financial year, much of this is down to one-off actions such as selling land. The high levels of concern about the year ahead suggest that NHS providers are again likely to run up a significant deficit in 2017/18, a year when the sector is supposed to be in balance.

“With many CCGs planning to delay or cancel spending, local NHS leaders will be forced to make tough decisions about priorities and this is likely to have a direct impact on what care patients can access and how long they have to wait for it.

“This reinforces the underlying reality that demand for services is continuing to outstrip the rate at which the NHS budget is growing.”

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