NHS trusts can’t deliver in 2017/18 without more realism, flexibility and support

20 March 2017

A detailed analysis by NHS Providers shows that what is currently being asked of NHS trusts in the coming financial year is well beyond reach. The report sets out how greater realism, flexibility and support are needed if trusts are to deliver in 2017/18.

The report, Mission impossible? The task for NHS providers in 2017/18, presents a detailed assessment of the demands that are being placed on NHS trusts through the NHS planning guidance. These are compared against next year’s significantly lower funding increases, revealing a currently unbridgeable gap.

The report sets out, in detail, the challenges facing the NHS in 2017/18. These include:

The report sets out three ways on how the 2017/18 NHS trust task could be made more deliverable:

The report points out the patient impact in 2017/18 of continuing on the current performance trajectory:

The report points to the increasing patient safety risk over the winter period with record levels of demand leading to potentially unsafe bed occupancy levels and rising numbers of long ambulance handover times and 12 hour trolley waits. It also highlights the increasing burden on NHS staff of trying to deliver impossible targets without adequate funding.

Commenting on the findings, the chief executive of NHS Providers, Chris Hopson, said:

"The NHS is a can-do organisation which achieves extraordinary results for patients every day. NHS trusts are treating more patients than ever before and performance remains good by international standards. So when those trusts say that they can’t deliver what’s currently being asked for next year, it is time to sit up and listen.

"It is unprecedented for us to warn the NHS will not be able to deliver on its commitments before the financial year has even started. But trusts are currently being asked to absorb a 5% plus cost and demand increase, recover the four A&E wait and 18 week surgery targets, improve care for cancer and mental health and balance next year’s books financially. All on a 1.3% funding NHS England funding increase, down from this year’s 3.6% increase. Taken together, this is mission impossible. The numbers don’t add up.

It is unprecedented for us to warn the NHS will not be able to deliver on its commitments before the financial year has even started.

 

"NHS trusts want to deliver NHS standards, achieve financial balance and improve performance. The standards on A&E and surgery were set for a good reason – they are a good proxy for the quality and access to care the NHS should provide. But trusts can only deliver if funding keeps pace with rapidly rising demand. In the absence of those funding increases, we need greater realism, flexibility and support from those leading the service.

"Trusts won’t be able to recover the A&E and elective surgery targets across the whole year. Just stabilising the rapidly increasing performance decline would be an achievement in itself. Given that demand and cost increases will easily outstrip funding and efficiency increases, just reproducing this year’s financial performance is a stretching target.

Given that demand and cost increases will easily outstrip funding and efficiency increases, just reproducing this year’s financial performance is a stretching target.

 

"We also need to redirect money to front line care and provide more support to help providers reduce unwarranted variation and improve performance as quickly as possible.

"There is also a very clear and simple warning in our analysis. We have now reached the point where, on the resources available, NHS trusts can no longer deliver what the NHS constitution requires."

 

 

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