Nearly two-thirds of NHS Trust finance directors and more than half of clinical commissioning groups (CCG) finance leads say the quality of patient care in their area has deteriorated over the past year, according to the latest Quarterly Monitoring Report from The King’s Fund.
The findings on the quality of care are the most worrying since The King’s Fund began tracking this question in 2012. Only 2% of Trust finance directors and 12% of CCG finance leads said that patient care had improved over the past 12 months.
Looking back over 2015/16 as a whole, the report underlines the increasing strain the NHS is under as it struggles to manage increasing pressure on services within constrained resources. Data analysis carried out for the report highlights deteriorating performance over the year in several key areas:
• 8% of patients, more than 1.85 million, spent longer than four hours in A&E across the year, the worst performance since 2003/4.
• The number of patients waiting for hospital treatment is estimated to have risen to 3.7 million, an increase of 17% (almost 500,000 patients) over the year and the highest number since 2007.
• At the end of March 2016, more than 5,700 patients were delayed in hospitals, an increase of 15% over the year and the highest number since 2008.
The latest survey also confirms that 7 out of 10 NHS providers ended 2015/16 in deficit (including 9 out of 10 acute Trusts).
Looking ahead to 2016/17, the survey found that, despite £1.8 billion in allocated funding and a concerted drive led by national NHS bodies to reduce overspending, more than half of trust finance directors expect their trust to end the year in deficit once again. Analysis undertaken for the report estimates that these deficits could add up to a £1.4 billion across the provider sector as a whole.
Detailed findings from the survey show that:
• 38% of Trusts and 61% of CCGs are concerned about meeting cost improvement targets in 2016/17.
• 82% of Trusts are either concerned or uncertain about meeting new control totals set by NHS regulators to reduce spending.
• Nearly 20% of CCGs expect to overspend their budgets this year, indicating that financial pressures are being felt by commissioners as well as providers.
John Appleby, chief economist at The King’s Fund, said: “Our latest survey confirms what we already knew, that 2015/16 was a very difficult year for the NHS, reflected in huge deficits and worsening performance. 2016/17 is a watershed year for the NHS in which it has been tasked with eradicating deficits and improving performance. Despite significant additional funding and a huge effort to contain deficits, it is clear that this is going to be a Herculean challenge.”
