A report on the future of the NHS: a rapid increase in the consumption of public money to provide worsening service?

Good Governance Institute | Published online: 29 September 2016

Image source: GGI

The Future of the National Health Service report presents the core arguments arising from the debate and explores recommendations and critical next steps required to safeguard the future sustainability of the health and care system.

The report analyses in some detail at the NHS in the midst of the most serious financial crisis since its inception and together with the wider care system, is experiencing the most austere era in its 68-year history. Both health and social care are facing a decade long funding squeeze which, it has been reported, will see spending as a share of GDP decrease leaving Britain behind many other advanced nations on this measure of spending. With an ageing population, a society in which the prevalence of long term medical conditions is ever increasing, the rising cost of care, a chronic underinvestment in social care and a reported cumulative 2015/16 provider deficit of £2.45 billion, the health system is teetering on the edge of a full blown crisis.

Read the full overview here

Read the full report here

A false economy: cuts to CPD funding for nursing, midwifery and the allied health professions

Council of Deans of Health | Published online September 2016

Image source: Council of Deans of Health

This report focuses on the impact of funding cuts across England to ongoing education and training for nurses, midwives and allied health professionals (AHPs) and the risks this poses to the NHS. With the constant evolution of treatments and technology, as well as rapidly changing roles for many healthcare staff, ongoing education and training is an essential foundation for safe, effective care. Health Education England (HEE), an arm’s length body of the Department of Health (DH), funds a measure of this education through Continued Professional Development (CPD) for the nurses, midwives and AHPs that make up more than 75% of the health professional workforce.

The funding supports the delivery of short courses, modules and programmes that meet the needs of the NHS workforce at national, regional and local levels. For 2016/17 this funding in England has been the subject of deep cuts of up to 45%, often without much warning and with little evidence of strategic planning at national level. Funding for postgraduate medical education has continued to be protected.

Although these cuts will adversely affect universities, the most significant impact will be on the NHS workforce and the NHS’s ability to meet its own strategic objectives. Given the profound changes that are expected to nursing, midwifery and AHP roles as demand for services grows and patient needs and service configurations change, this transformation is at risk without investment in education and training. CPD is also equally important for sustaining core NHS services, such as accident and emergency and intensive care, where specialist and advanced practice knowledge and skills are required for staff to be able to deliver safe, up to date care.

There is already evidence that the significant cuts to mentorship budgets are damaging mentorship training for NHS staff, which is central to the current strategy to expand preregistration programmes in the coming years. The Government’s strategic priorities and these funding decisions simply do not add up

Read the full report here

NHS Shared Planning Guidance

NHS Operational Planning and Contracting Guidance 2017 – 2019

NHS England and NHS Improvement have published this year’s operational and contracting planning guidance three months earlier than normal to help local organisations plan more strategically.

Image source: http://www.england.nhs.uk

For the first time, the planning guidance covers two financial years, to provide greater stability and support transformation. This is underpinned by a two-year tariff and two-year NHS Standard Contract.

It provides local NHS organisations with an update on the national priorities for 2017/18 and 2018/19, as well as updating on longer term financial challenges for local systems.

Key facts

  • The planning process has been built around Sustainable Transformation Plans so that the commitments and changes coming out of these plans translate fully into operational plans and contracts
  • The timetable has been brought forward to enable earlier agreement locally about contracts
  • Adjustments have been made to national levers such as tariff and CQUIN to support local systems in implementing service transformation
  • In line with our expectation of greater collaboration between organisations locally, there will be a single NHS England and NHS Improvement oversight process providing a unified interface with local organisations to ensure effective alignment of CCG and provider plans.

Long term conditions

NHS England has published The Long Term Conditions Year of Care Commissioning Programme Implementation Handbook.

Image source: http://www.nhsiq.nhs.uk/

The handbook is the main output of the Year of Care Commissioning Programme. It describes the experiences of five care economies working as part of the programme as they work towards developing capitated budgets for some patients and services.

A range of new posters are available showing how early implementer sites from the Long Term Conditions Year of Care Commissioning Programme are using their outputs from the programme to proactively support local service change decision making:

Sort film: Revolutionising person centred care for people with complex care needs

Is the NHS financially sustainable?

Latest updates from the Nuffield Trust

NHS Framework Documant 2008

The NHS is going through a decade of austerity, but demand for health care continues to rise. Clearly, the NHS needs more money in the short term, but what about the future?

This is the subject of a House of Lords inquiry into the sustainability of the health service up to 2030. New spending projections from the Office for Budget Responsibility estimate a rise in public spending to 8.8 per cent of GDP in 15 years. In analysis of the estimates, John Appleby argues that it will be possible to fully fund the NHS in the future. The bigger question is who will pay for it.

A digital NHS?

In recent years, the digital agenda in health care has been the subject of a number of promises and plans, ranging from the Secretary of State’s challenge to the NHS to ‘go paperless’ to the commitment set out in the NHS’s Five Year Forward View to ‘harness the information revolution’.
This briefing from The Kings Fund asks if expectations been set too high? And is there sufficient clarity about the funding available to achieve this vision?

The paper looks at the key commitments made and what we know about progress to date, grouped under three broad themes:

  • interoperable electronic health records
  • patient-focused digital technology
  • secondary use of data, transparency and consent.

It identifies barriers to further progress and opportunities for delivering on the digital agenda.


The NHS in 2016

The Royal College of Physicians (RCGP) has published Underfunded, underdoctored, and overstretched: The NHS in 2016.

Image source: http://www.rcplondon.ac.uk/

This report is the first of a series in the RCGP ‘Mission: Health’ campaign which will be focused on three major themes working for health, delivering health, and creating health.  In this report, the RCGP believes that the NHS needs a new plan for the future which is  designed to meet the UK’s health and care needs in the long term, and to value, support and motivate NHS staff.

Additional link: RCGP press release