Public health grants

The Department of Health and Social Care has published Public health local authority allocations 2018 to 2019 and indicative allocations 2019 to 2020.  In the financial year ending 2019, local authorities will receive £3.215 billion public health grant for their public health duties for all ages.


Royal Commission on the NHS

A Royal Commission on the NHS: the remit | The Centre for Policy Studies

With the NHS facing another winter crisis, leading to the cancellation of tens of thousands of non-urgent operations in January, there has been a groundswell of support for a Royal Commission to safeguard its future.

This document sets out how the setting up of a Royal Commission could ensure the NHS delivers the best outcomes on a sustainable financial basis over the coming years.  A Royal Commission would examine the structure, organisation and funding of the health service, taking evidence and making policy recommendations.

Read the full document here



Brexit: the implications for health and social care


Almost 18 months ago, the Kings Fund published an article that considered some of the most important implications for health and social care in England in the wake of the UK’s vote to leave the EU. This update looks at the developments that have taken place since the 2016 referendum.

The authors report that Brexit appears to already be having an impact, especially on the recruitment and retention of EU nationals in some parts of the workforce which is contributing to shortages of key staff.

Full report: Brexit: the implications for health and social care

NHS financial briefing

The Healthcare Financial Management Association (HFMA) has published NHS financial temperature check: finance directors’ views on financial challenges facing the NHS in England. This is the eighth in a series of briefings setting out finance directors’ views on the financial issues facing the NHS in England. The briefing draws on the responses of 80 finance directors of trusts and foundation trusts and chief finance officers of 56 CCGs.

NHS trusts predicting worse deficit than originally anticipated

Quarterly performance of the NHS provider sector | NHS Improvement

The quarterly performance of the NHS provider sector for the second quarter (July to September) of the 2017-18 financial year reveals that NHS trusts and foundation trusts are collectively predicting a full-year deficit of around £623 million – £127 million worse than planned.

The data from NHS Improvement also showed that despite the NHS treating more patients than even before, more people were seen within four hours in A&E and within 18 weeks for planned care.

Between July to September of this year, 90.2% of emergency patients were seen within four hours – meeting the national ambition of 90% by September while 3.43 million patients were seen within 18 weeks, compared with 3.36 million during the same period last year.

Cost improvement programmes had delivered £1.25 million of improvements in the first six months of the year and hospitals had delivered a £119 million reduction in temporary staffing for the first six months of the financial year, compared to the same period last year.

Full detail at NHS Improvement

Understanding the NHS deficit and why it won’t go away

This briefing assesses the financial health of those providers by unpicking the headline figures presented in the official accounts to reveal the true underlying state of the NHS’s finances today, and to outline prospects for the next three to four years | Nuffield Trust

Image source: Nuffield Trust
  • NHS trusts have begun the current financial year, 2017/18, on course for an underlying overspend or deficit of £5.9 billion. To meet their reported deficit target of £500 million, they will need to cut their operating costs by £3.6 billion and receive temporary extra funds of £1.8 billion.
  • This would require trusts to make savings in one year equivalent to 4.3 per cent of their operating costs – far in excess of any level achieved over recent years and likely to be almost impossible to deliver.
  • A more likely scenario is that they will make cost savings similar to the level made last year. That would collectively leave the trusts with an underlying deficit of around £3.5 billion.
  • The headline deficit for 2016/17 (which ended in March 2017) was £791 million. However, that figure was flattered by billions of pounds’ worth of one-off savings, temporary extra funding and accountancy changes that did nothing to improve the underlying state of provider finances. Once they are removed, the underlying deficit for 2016/17 is £3.7 billion.
  • This is compared to an underlying deficit the year before, 2015/16, of £4.3 billion. As trusts also had to soak up additional inflation costs in 2016/17, the reduction in the underlying deficit between 2015/16 and 2016/17 actually represents providers making £2.3 billion in permanent savings.
  • Projections of future years suggest that, even under optimistic assumptions for inflation and continued high levels of savings, NHS providers will continue to run a large collective underlying deficit until at least 2020/21.

Read the full briefing here