Responding to the NHS planning guidance for 2019/20, published today by NHS England and NHS Improvement, the chief executive of NHS Providers, Chris Hopson, said:

“NHS trusts have been struggling for four years with a difficult combination of rising demand, the longest and deepest financial squeeze in NHS history and growing workforce shortages. That’s meant that, despite frontline staff working flat out, the NHS has fallen a long way behind. Patient access to care has suffered, trusts have been running persistent financial deficits and frontline NHS staff have had an unsustainable workload.

“The 2019/20 planning guidance, and this week’s long term plan, therefore needed to show how trusts, working in their local systems, could use the first year of increased NHS investment to start to deliver the interlinked objectives of recovering performance, addressing workforce shortages and heading back to financial balance.

The 2019/20 planning guidance, and this week’s long term plan, therefore needed to show how trusts, working in their local systems, could use the first year of increased NHS investment to start to deliver the interlinked objectives of recovering performance, addressing workforce shortages and heading back to financial balance.

“The provider sector will welcome the overall new financial regime set out in the guidance – the extra investment in the sector, the increase in prices paid to trusts for the care they provide, the new provider financial recovery fund, the changes to funding emergency care and a more realistic efficiency assumption than before of 1.1%.

“Trusts will want to assess the impact of a complex set of changes on their individual position, recognising that each trust has an important contribution to make to returning the sector to financial balance. But, taken as a whole, this should enable the provider sector to start moving from deficit to surplus, an important and significant achievement.

Trusts will want to assess the impact of a complex set of changes on their individual position, recognising that each trust has an important contribution to make to returning the sector to financial balance. But, taken as a whole, this should enable the provider sector to start moving from deficit to surplus, an important and significant achievement.

“On workforce, trusts will also welcome the statement of intent to rapidly address current staff shortages. Whilst it’s concerning that some issues, and a full plan, will need to wait for the forthcoming spending review, it’s welcome that the new national workforce group plans to take quick, co-ordinated, purposeful action in areas that trusts and NHS Providers have been highlighting for some time. These include speeding up overseas recruitment, quickly maximising the clinical permissions that newer job roles can exercise and tackling long standing pension issues. The new group must fully involve frontline trust leaders and their representatives in its work.

Whilst it’s concerning that some issues, and a full plan, will need to wait for the forthcoming spending review, it’s welcome that the new national workforce group plans to take quick, co-ordinated, purposeful action in areas that trusts and NHS Providers have been highlighting for some time.

“On recovering performance, the guidance acknowledges that current performance is short of where it should be but says that a recovery plan needs to wait for a new set of performance targets that reflect up to date clinical practice. Trusts are ready to look at modernising targets but will not want to abandon the hard won improvements in waiting times and patient care the NHS delivered in the 2000’s. Any recovery trajectory needs to be properly planned and fully funded and staffed. We will also need a full, evidence based, debate to change the current NHS constitutional standards. The six month timetable suggested in the planning guidance for achieving this seems ambitious.

Trusts are ready to look at modernising targets but will not want to abandon the hard won improvements in waiting times and patient care the NHS delivered in the 2000’s. Any recovery trajectory needs to be properly planned and fully funded and staffed.

“The single biggest factor affecting the NHS in 2019/20 may well be the impact of Brexit, should it proceed, particularly if there is a no deal Brexit. Trusts tell us they are completely reliant on national level contingency planning and remain concerned at the short timetable and the range and complexity of tasks that need to be managed.

“In short, the planning guidance sets out the first steps on the path back to a sustainable NHS, with the right care for patients and a reasonable workload for staff. Good work has been done to enable providers to start to recover their financial position. But there is a lot of hard work to do and independent commentators are clear that there is insufficient money to meet every aspiration”.