Hospital Dr News

Levels of NHS performance expected and savings demanded are beyond reach, report says

NHS trusts must be set more realistic productivity targets given the current demand for their services, a report concludes.

The report by NHS Providers suggests that despite making efficiencies the provider sector is at least £930m in deficit, over £750m more than planned, taking account of the Budget’s extra winter funding.

Far from recovering, A&E performance has dropped to the worst levels ever recorded, and waits for routine surgery have significantly increased.

There are similar pressures in the community, mental health and ambulance sectors.

The report shows that the tasks set for trusts for 2018/19 once again look impossible.

On A&E performance, NHS Provider data shows that only 5% of trusts are confident their area can meet the four-hour A&E target next year.

The report shows that the number of trusts needing to improve and the scale of improvement needed to hit the required performance target is extremely ambitious.

On elective surgery waiting lists, 55% of trusts are worried they will not be able to contain the size of their list next year.

Given that elective volumes have fallen this year due to winter pressures, workforce and capacity constraints, the assumed increases in outpatient appointments (5%) and elective admissions (3.5%) are too optimistic.

On finances, trusts say they would need to deliver more than £4bn worth of savings next year – 20% higher than this year – to deliver the required collective breakeven position.

Only 54% indicated they would sign up to their allocated financial target (control total) and, of these, only 35% believed they could meet this target.

NHS Providers wants to reset the NHS national planning framework from 2019/2020 onwards.

NHS frontline organisations must be a key part of the national level planning process alongside national bodies, it says.

National frameworks must be based on realistic projections and assumptions about demand and speed of change. Funding must match the task in hand recognising that, on current resources, we can no longer deliver or recover the NHS constitutional standards.

A fully funded, effective, short- and longer-term plan is also needed to address current workforce shortages, which are significantly affecting trusts’ capacity to deliver.

All this is despite trusts treating more emergency patients than ever before. They are delivering 1.8% efficiency gains, nine times the UK whole economy average. And, they are on course to realise more than £3bn in savings.

But, it is not nearly enough, the report concludes.

Chris Hopson, CEO of NHS Providers, said: “Our analysis shows the levels of performance expected and the savings demanded for next year are beyond reach.”

Dr Robert Harwood, BMA acting consultants committee chair, said: “While the prime minister’s promise to address the health service’s long-term funding needs were a good first step, this report is a timely reminder of the uphill struggle facing the NHS after decades of underinvestment.

“The report clearly highlights something that doctors in both secondary and primary care and their patients have long known: that there are now simply too few beds for patients available in the NHS to allow the delivery of safe, effective care at the time it is needed.”

Read the report.

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