Control totals and financial planning

This survey was circulated to the finance and commercial directors across NHS trusts and foundation trusts in England in February 2017. It received responses from 99 providers, equal to 42% of the provider sector.

It asked questions concerning how financial plans are progressing for the next financial year, what the financial outlook is, and how providers have responded to the issues related to control totals.

The results of the survey clearly indicate that the provider sector has been set an unprecedentedly challenging financial task for 2017/18.

The results of the survey clearly indicate that the provider sector has been set an unprecedentedly challenging financial task for 2017/18. Control total savings targets are far larger than those outlined in the national tariff, and represent a ratcheting up of the already challenging savings required in 2016/17 

On top of this, non-recurrent savings made this year mean that those targets are even more difficult to reach. Finally, some of the difficulties of moving towards ever greater financial collaboration within sustainability and transformation plans (STPs) are also clearly demonstrated.

Providers highlight concerns around governance and financial regulation in signing up to system control totals, in particular the issue that while providers are expected to collaborate at a local health economy level, they are still held to account and regulated as standalone institutions.

Key findings

Approaching the end of 2016/17: most providers are on plan, but are approaching an unsustainable position next year

Looking ahead to 2017/18: a gradually improving aggregate financial position, but little flexibility and confidence among providers

Control totals: a gap between those who signed and those who didn’t, and a lack of confidence in their ability to support system change

Download the full survey report below.

 

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