NHS future in doubt without extra funding as trusts record “staggering” deficit

NHSreality, assuming these facts are correct, suggests overt rationing with co-payments, exclusions and predictability by advanced announcement could get over the problem still. But the shifting sands on which the different health services are founded are clear to all. Mr Hunt can time it to submersion..

Gareth Iacobucci in the NMA News section of the BMJ reports 9th October 2015 (BMJ 2015;351:h5430 ): NHS future in doubt without extra funding as trusts record “staggering” deficit

NHS hospital trusts in England recorded a combined deficit of almost a billion pounds in the first three months of this year, higher than the deficit for the whole of the previous financial year.

Figures published by national regulators Monitor1 and the NHS Trust Development Authority2 showed that the NHS trust and foundation trust sectors recorded a combined deficit of £930m (€1260m; $1420m) in the first quarter of 2015-16, compared with £822m for the whole of 2014-15.3

The disclosure lays bare the rapidly deteriorating financial position at most NHS hospitals and indicates that the £2bn end of year deficit previously forecasted for NHS trusts finances is likely to be exceeded.

Monitor’s figures showed that 118 of England’s 151 foundation trusts (78%) ended the period in deficit with a cumulative deficit of £445m. The regulator said that 75% of these foundation trusts were acute or specialist trusts.

In the non-foundation trust sector, the NHS Trust Development Authority disclosed a £485m combined deficit for NHS trusts (covering acute, ambulance, community, and mental health trusts), with 72 of 90 trusts (80%) in deficit after the first three months of 2015-16.

Monitor’s figures showed that the foundation trust sector recorded a total wages bill of £7411m (which was £59m more than planned), and made £232m worth of cost savings (which was £64m less than planned).

Healthcare leaders warned that a decline in patient care was inevitable without emergency funding being made available and urged the government to take urgent action to address the crisis.

Ian Wilson, chair of the BMA’s representative body and a consultant in pain medicine and anaesthesia, described the figures as “staggering.” He said in a statement, “The NHS is facing a funding crisis the likes of which we have never seen. Despite what politicians claim, NHS funding has not kept up with rising patient demand and the increased cost of delivering care. The extra funding promised by the government is barely enough for the NHS to stand still. The result is a health service that is bucking at the seams, relying on emergency bailouts and with no real solution to the £22bn funding gap facing it.”

He added, “The government must wake up and take action.”

Richard Murray, director of policy at The King’s Fund, said, “The government must now acknowledge it cannot continue to maintain standards of care and balance the books. Unless emergency funding is announced in the forthcoming spending review, a rapid and serious decline in patient care is inevitable.”

This view was echoed by The Health Foundation’s chief economist Anita Charlesworth, who urged the government to fund an NHS wide transformation programme to ease the pressures, as recommended by the Health Foundation and the King’s Fund.4

“Investing in improving efficiency rather than bailouts for overspending is key to a financially sustainable, high quality service for patients and a much better use of taxpayers’ money,” said Charlesworth.

Nigel Edwards, chief executive of the Nuffield Trust, said that the “bleak” outlook made it difficult to envisage the government meeting its deadline to balance the books by April 2016. He added, “Given the scale of these deficits, there appears to be an extraordinary absence of the sort of urgency one might expect from those in charge of the NHS.”

Chris Hopson, chief executive of NHS Providers, the association representing NHS public provider trusts, said, “Trusts are doing everything they possibly can to avoid financial deficits, but they are experiencing a triple whammy: rapidly rising patient demand; an extra £2bn unfunded staff cost they have been required to add; and the deepest and longest funding squeeze in NHS history.”

Clive Peedell, coleader of the National Health Action Party and an oncologist in Middlesbrough, said, “These catastrophic figures, whose release was delayed until after the Tory party conference, are a direct result of this government’s chronic underfunding and counterproductive policies and efficiency savings.”


Cite this as: BMJ 2015;351:h5430


This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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