NHS is fighting a losing battle without extra funding for neglected areas
18 November 2016
Extra funding for general practice and social care are vital if the NHS is to have a chance of restoring financial balance and ensuring patients don’t wait longer for treatment, according to NHS Providers.
With rising demand for care and constrained budgets leading to more than 150 trusts being in deficit and the majority of NHS trusts not meeting their performance targets, NHS Providers is urging the government to use its autumn statement on 23 November to deliver extra funding beyond hospitals and into the areas of greatest need. These recommendations are outlined in a six-point autumn statement submission made by NHS Providers to the Treasury.
At the top of the priority list for investment should be general practice and social care. Both areas are under severe pressure.
As a result, significant numbers of patients who could and should be dealt with outside of hospital are attending A&E departments instead. At the end of last year only four out of 138 large A&E departments were meeting the required four-hour standard. And, on any given day, up to 6,800 beds in hospitals are occupied by patients who are medically fit to leave hospital but cannot leave due to a lack of available services in the community and social care. The cost of these delays to NHS trusts is estimated to be around £820 million per year.
Measures to improve services outside hospitals can have a profound affect on the acute sector’s ability to provide the best care for their local communities
Investing in these areas will help the NHS to reduce delayed transfers of care, improve patient care and ease the burden on A&E departments and other hospital, mental health, community and ambulance services. NHS Providers’ proposals emphasise how measures to improve services outside hospitals can have a profound affect on the acute sector’s ability to provide the best care for their local communities. Spending commitments arising from any additional funding for social care should be agreed with local NHS trusts so that the funding is directed towards tackling the issues that are causing most problems to the NHS.
NHS Providers chief executive Chris Hopson said:
“There is now a clear gap between what the NHS is being asked to deliver and the funding available. NHS trusts are working flat out to develop new and better ways of delivering patient care, but they urgently need targeted extra investment in the areas of greatest need. Investing in general practice and social care, as well as stopping the raids on capital spending to ensure our hospitals and other buildings are fit for purpose, must be an urgent priority.
“This would help GPs and care services to ease the rising pressure on hospital, ambulance, community and mental health trusts, which in turn would improve the quality of care people receive. The NHS has shown that with the right support it can transform services and deliver efficiency savings, so we believe these measures would produce a strong and immediate return on investment for the Treasury.
There is now a clear gap between what the NHS is being asked to deliver and the funding available
“The investment must be accompanied by a rethink of plans for this parliament. Providers will do all they can to improve productivity, realise efficiencies and move to new ways of providing care. But over the next three years demand and cost will rise by at least 4% a year whilst real terms health funding per head is flat or actually reduces. We therefore have to decide what the NHS should prioritise. The NHS simply cannot do all that it is currently doing and is being asked to do in future on these funding levels.”
The six key recommendations in the Treasury submission are:
- General practice: funding should be targeted at supporting GPs to plug capacity gaps and manage demand more effectively in primary care to reduce referrals to more expensive hospital-based care.
- Social care: bring forward planned investment in social care during this parliament, which will see an additional £1.5 billion a year in cash terms provided by 2019/20 through the better care fund. In addition, councils should have freedoms to raise the social care ‘precept’ further to invest in social care services.
- Refocus on the need for capital investment: repeated raids on capital funding to reduce deficits are unsustainable. The chancellor has already indicated he is likely to increase investment in capital infrastructure and, as a vital public service, the NHS should be a key beneficiary.
- Achieving efficiency savings: NHS trusts delivered £2.9 billion in cost improvement savings over 2015/16, but the easier savings have now been realised. Given the huge current operational pressure on the service there simply isn’t enough current capacity in trusts to realise the next set of efficiencies, including those identified in the Carter review. The submission therefore argues for investment in extra capacity in this area.
As well as these four areas, NHS Providers is calling for a more fundamental reassessment of what the NHS service can deliver for the money available.
- Re-plan for the rest of this parliament: there is an urgent need to look again at what the NHS is able to deliver this parliament given the proposed funding.
- Understanding the 2020-2040 challenge: the massive extra demographic pressures the NHS faces after 2020 provide the service with an existential challenge. We are in danger of making short term decisions – for example reducing bed capacity – without a full understanding of this mid to long term context. The submission therefore calls for an officially supported analysis of the nation’s likely longer term health and care needs and how these will be met and funded so we can ensure we make the right short term decisions.
Read our autumn statement submission in full.