The impact of NHS financial pressures – a mixed picture

Recent figures reveal a provider deficit of nearly £900 million for the first three quarters of 2016/17 – a clear sign that NHS organisations are struggling in the face of constrained budgets and growing demand | Lillie Wenzel – The King’s Fund Blog

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As NHS organisations seek to manage current pressures, the number of media stories suggesting that tight health budgets are having a negative impact on patient care is increasing. But is this the whole picture?

For the NHS, the relationship between financial performance and quality of care is complex. Indeed, a recent Public Accounts Committee report recommended that the Department of Health and NHS England undertake work to better understand the association between the two. We know that the actions NHS organisations take when they are under financial pressure can affect patient care in a number of ways. We also know that patient care is affected by many factors besides funding, and that both national data and public attention tend to focus on care delivered within hospitals.

Our research, set out in Understanding NHS financial pressures, aimed to get beneath the top-level data and explore in more detail how patients are being affected by the financial pressures facing the NHS. We looked at four different service areas – genito-urinary medicine (GUM), district nursing, elective hip replacement and neonatal – to try to understand the impact in different parts of the system.

Read the full blog post here

NHS efficiency map

The Healthcare Financial Management Association and NHS improvement have updated the NHS efficiency map.

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This map promotes best practice in identifying, delivering and monitoring cost improvement programmes in the NHS.

 

It contains links to a range of tools and guidance to help NHS organisations improve their efficiency and includes sections on enablers for efficiency, provider efficiency and system efficiency.

 

Nurse shifts left unfilled at nearly every hospital in England

Analysis of official data finds 96% of NHS hospital trusts had fewer nurses covering day shifts than they had planned | The Guardian

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Almost every hospital in England has fewer nurses on duty than each believes are needed to guarantee safe patient care, research shows.

Analysis of official data by the Health Service Journal (HSJ) found that 96% of NHS hospital trusts in England had fewer nurses covering day shifts in October than they had planned and 85% did not have the desired number working at night.

The disclosure of such widespread failure to ensure hospitals are properly staffed has prompted fresh concern that a chronic lack of nurses and the NHS’s dire finances are putting patient safety at risk.

Read the full news story here

Children’s Mental Health Funding Not Going Where it Should

YoungMinds analysis reveals that many local health bodies are diverting some of the new funding received for children’s mental health services to other priorities.

In 2015, the government pledged an extra £1.4 billion over five years to “transform” Child and Adolescent Mental Health Services (CAMHS). Research undertaken by YoungMinds into the responses of 199 Clinical Commissioning Groups (CCGs) from Freedom of Information requests has revealed that:

  • Fewer than half of the CCGs who responded were able to provide full information about their CAMHS budgets. If CAMHS services are to improve, there needs to be far greater accountability about where money is being spent.
  • In the first year of extra funding (2015-16), only 36% of CCGs who responded increased their CAMHS spend to reflect their additional government funds. Nearly two-thirds (64%) of CCGs used some or all of the extra money to backfill cuts or to spend on other priorities.
  • In the second year of extra funding (2016-17), only half of CCGs (50%) who responded increased their CAMHS spend to reflect their additional government funds. The other half (50%) are using some or all of the extra money for other priorities.

Read the full news story here

Departmental Overview 2015-16: Department of Health | via @NAOorguk

This Departmental Overview looks at the Department of Health (DH) and summarises its performance during the year ended March 2016 | NAO

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Image source: NAO

This guide is designed to provide a quick and accessible overview of the Department and focuses in particular on where we believe the Department’s performance could be improved, using examples from our published work.

It covers:

  • The department’s responsibilities and how it spends its money
  • Financial management
  • Reported performance
  • Issues identified in NAO reports

Read the full report here

NHS pressures undermining relations between doctors and managers

A new survey of hospital managers and senior doctors finds signs that they are working together better than in the past, but warns relations have been damaged by reorganisation and financial pressures | Nuffield Trust

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The poll of 472 leaders and clinicians in management roles is published today in the Nuffield Trust report Managing doctors, doctors managing, along with results from interviews, a focus group and a review of academic literature. It finds that 60% now believe local doctor-manager relationships are positive, up from 47% in a 2002 study, and respondents are now more confident that managers put patient care first. However, a higher proportion of respondents (37%) now believe relations are likely to deteriorate over the coming year, compared to only 13% in 2002.

Read the overview here

Read the full report here

NHS efficiency map

The Healthcare Financial Management Association and NHS Improvement have worked in partnership to update and revise the NHS efficiency map.

 
The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) in the NHS. The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency.

The national focus on improving efficiency and productivity will mean taking local action to deliver savings remains a priority for all NHS organisations. Aimed at NHS finance directors and their teams and other NHS staff with an interest in the delivery of CIPs, the purpose of the NHS efficiency map is to highlight existing resources on eliminating waste, increasing efficiency and at the same time improving quality and safety.

The map is split into three sections: enablers for efficiency, provider efficiency and system efficiency.

 

The map highlights the successes some NHS providers have had in delivering specific efficiency schemes and provides sign-posts to existing tools and reference materials. It also includes updated definitions for different types of efficiency.

The map can be downloaded here