NHS capital expenditure and financial management #covid19rftlks

NHS capital expenditure and financial management | House of Commons Public Accounts Committee 

This report expresses concerns about widely reported shortages of personal protective equipment for clinical and care workers during the first wave of the Covid-19 pandemic and says Government is still not treating this with sufficient urgency.

It argues that the NHS needs a coherent plan for how it will function after the peak of the Covid-19 crisis with regard to issues such as workforce shortages, capital investment strategies, and tackling trust deficits.

Full report: NHS capital expenditure and financial management

See also: Committee demands detailed plan for PPE from DHSC within 2 months, ahead of potential second Covid wave

Are some ethnic groups more vulnerable to COVID-19 than others? #covid19rftlks

Institute for Fiscal Studies | May 2020 | Are some ethnic groups more vulnerable to COVID-19 than others?

According to analysis undertaken by the Institute for Fiscal Studies  (IFS) In the short term, ethnic inequalities are likely to manifest from the COVID-19 crisis in two main ways:

  • through exposure to infection and health risks, including mortality;
  • through exposure to loss of income.

Some of the report’s key findings:

  • The impacts of the COVID-19 crisis are not uniform across ethnic groups, and aggregating all minorities together misses important differences.
  • Per-capita COVID-19 hospital deaths are highest among the black Caribbean population and three times those of the white British majority.
  • Once you take account of age and geography, most minority groups ‘should’ have fewer deaths per capita than the white British majority.
  • Occupational exposure may partially explain disproportionate deaths for some groups.
  • Men from minority groups are more likely to be affected by the shutdown.
  • Self-employment – where incomes may currently be especially uncertain – is especially prevalent amongst Pakistanis and Bangladeshis.

The IFS’ report outlines how analysis that aggregates groups together masks much of the story with regards to ethnic inequalities, and limits the scope for understanding why they have come about. Moreover, simply comparing mortalities with overall populations fails to take account of key characteristics of different groups that we would expect to lead to different outcomes in the aggregate, such as demographics and place of residence.


The report collates evidence on the unequal health and economic impacts of COVID-19 on the UK’s minority ethnic groups, presenting information on risk factors for each of the largest minority groups in England and Wales: white other, Indian, Pakistani, Bangladeshi, black African and black Caribbean. For the most part, the IFS focus on these six groups (and the white British majority) for which there is reliable information across different data sources.

Click to access Are-some-ethnic-groups-more-vulnerable-to-COVID-19-than-others-IFS-Briefing-Note.pdf

Download the report from the IFS

In the news:

The Guardian British BAME Covid-19 death rate ‘more than twice that of whites’

NHS to benefit from £13.4 billion debt write-off

Health Secretary announces over £13 billion of debt will be written off as part of a major financial reset for NHS providers | Department of Health and Social Care

From April 1, over £13 billion of NHS debt will be scrapped as part of a wider package of NHS reforms announced by the Health Secretary.

  • More than a hundred NHS hospitals to be rid of historic debt, freeing them up to invest in maintaining vital services and longer-term infrastructure improvements
  • Comes alongside new NHS funding model to make sure the NHS has the necessary funding and support to respond to the coronavirus (COVID-19) pandemic

The changes will provide much needed financial support during this unprecedented viral pandemic, as well as laying secure foundations for the longer-term commitments set out last year to support the NHS to become more financially sustainable.

Full story at Department of Health and Social Care 


Public health grants to local authorities: 2020 to 2021

The public health allocations and monetary conditions for local authorities to improve health in local populations | Department of Health and Social Care

Local authorities are responsible for improving the health of their local population and reducing health inequalities. In the financial year ending 2021, local authorities will receive a £3.279 billion public health grant for their public health duties for all ages.

This local authority circular sets out the allocations and conditions for using the grant.

Full detail at Department of Health and Social Care

NHS corporate governance map

Healthcare Financial Management Association (HFMA)| March 2020 | NHS corporate governance map 

The Healthcare Financial Management Association (HFMA) is the professional body for finance staff working in healthcare

HFMA NHS corporate governance map has been updated. The map brings together the key guidance and models to support effective corporate governance within the NHS. This update provides links to new items from national bodies, such as the planning and contracting guidance 2020/21 and  counter-fraud standards 2020/21, as well as recent briefings from HFMA to support members as the financial year end approaches, such as Year-end reminders for non-executive directors and The external audit: best practice in working well together


Image source: hfma.org.uk

The map is split into four sections: strategic framework; enabling good governance; specific areas for assurance; and devolved nations. It signposts the key model documents and guidance available, and when they were last updated (Source: HFMA).

NHS corporate governance map

NHS financial management and sustainability

This eighth report on the financial sustainability of the NHS summarises the financial and operational performance of the NHS as a whole in England in 2018-19; examines the financial performance of local NHS organisations; and examines NHS service transformation and sustainability.  

The report finds that the NHS is treating more patients but has not yet achieved the fundamental transformation in services and finance regime needed to meet rising demand. It argues that the short‑term fixes that DHSC, NHS England and NHS Improvement put in place to manage resources in a constrained financial environment are not sustainable. The extra money brought in to stabilise the finances of NHS bodies has continued to drive volatility and variability among trusts, while patient waiting times continue to deteriorate and the number of people waiting for treatment continues to increase.

To bring about lasting stability, the report states that the NHS needs a financial restructuring programme not just a recovery programme. If integrated care systems are to be successful it claims, funding mechanisms and incentives need to support collaborative behaviours.

Full report: NHS financial management and sustainability| National Audit Office

Financial Performance Report

Financial performance report: first quarter 2019/20 | NHS England and NHS Improvement 

This report provides an update on the financial performance of NHS England and includes the year to date and forecast position for CCGs, areas of direct commissioning, central running costs and programme budgets. It also includes year to date and forecast performance against commissioner efficiency plans.

Full detail at NHS England

Finance, Commissioning and Contracting Handbook

NHS England | August 2019 | Finance, Commissioning and Contracting Handbook

NHS England have published the Finance, Commissioning and Contracting Handbook for the NHS England Comprehensive Model for Personalised Care. It aims to provide finance, commissioning and contracting staff with the information required to implement personalised care locally.

Finance, Commissioning and Contracting Handbook

How Does UK Healthcare Spending Compare With Other Countries?

This briefing provides an analysis of UK health care spending relative to comparable countries, such as the G7 group of large developed economies or member nations of the Organisation for Economic Co-operation and Development (OECD) | Office for National Statistics


It finds that the UK spent an average of £2,989 per person on health care in 2017 which is the median for OECD countries. However, of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).

Other key findings:

  • As a percentage of GDP, UK healthcare spending fell from 9.8% in 2013 to 9.6% in 2017, while healthcare spending as a percentage of GDP rose for four of the remaining six G7 countries.
  • The UK’s publicly funded NHS-based health system contributes to the UK having one of the highest shares of publicly funded healthcare (79%) in the OECD.
  • In 2017, the UK spent the equivalent of £560 per person on health-related long-term care, which was less than most other northern or western European countries, but a similar amount to France (£569) and Canada (£556).

Full document: How does UK healthcare spending compare with other countries?
An analysis of UK healthcare spending relative to comparable countries, using data produced to the international definitions of the System of Health Accounts.