We recently published the NHS reality check: the financial and performance task for trusts report, which explores how, despite the efforts of trust leaders and frontline staff working flat out to deliver more care for patients and service users, some elective recovery targets may take longer to deliver than expected.

Rising demand for NHS services combined with severe workforce pressures and an underfunded social care system means there is a still a long road ahead for trusts in tackling care backlogs. The report highlights how the pandemic has deepened existing pressures, leaving trusts facing a tough task in 2022/23 to meet patient need within the current funding settlement while delivering stretching efficiency targets.

A recent cash injection of an extra £1.5bn by NHS England has been welcomed by trust leaders as a recognition of the inflation challenge. But questions remain over whether this funding – which has been redirected from elsewhere across NHSE’s budget – will significantly improve the financial health of the provider sector, given the range of cost pressures trusts face. 

The report includes findings from a survey of trust leaders, with 95% of respondents saying the financial ask for the coming year would be difficult or extremely difficult and 92% saying persistent workforce shortages were the most significant barrier to increasing activity. In addition, 67% were confident or very confident that they would eliminate year-long waits for routine operations by March 2025, but only 37% thought they would be able to deliver the required increased activity levels this year. Finally, 51% were not confident that their system would be able to deliver its targets to reduce long waits across mental health services.

Governors may wish to seek assurance from their boards about their plans to tackle key performance issues, such as backlogs of care, waiting lists across both physical and mental health service, or ambulance handover delays within the resources available.