The state of NHS finances at Q1 2016/17
A total of 84 providers responded to the survey, representing 35% of England's 238 provider trusts.
The survey found that:
- While almost half (47%) of trusts were ahead of their target at the end of the first quarter and a third were on target, the final fifth (21%) were worse-off than anticipated.
- Finance directors from almost 4 in 10 (38%) trusts are not confident of meeting the financial targets (so called ‘control totals’) they have been set by regulators for the end of 2016/17. A third were ‘unsure’ and the final third were ‘fairly confident’. Some of the main reasons for concern included: not being able to reduce agency staff costs, lack of bed capacity, not being able to manage the rise in A&E attendance and emergency admissions to hospital, and the ongoing impact on the NHS of cuts to social care.
- Further doubts about the sustainability of the first quarter results were raised by the way trusts can access the £1.8 billion ‘sustainability and transformation funding’. As a number of finance directors pointed out in the survey, there are significant incentives on trusts to declare they are on track at quarter one to ensure access to the sustainability and transformation funding, which they might otherwise lose.
- Finance directors were also asked how effective they believe the recent wave of financial measures introduced by NHS Improvement and NHS England were likely to be. These include tough control totals and placing some trusts into financial special measures. However, most finance directors have little or no confidence that these measures will help the NHS to achieve financial sustainability this year. Specifically, more than half (54%) were not confident that financial special measures for trusts would work, while 58% were not confident in measures to curtail increases in staff costs.