The latest quarterly monitoring report from The King's Fund once again illustrates the huge pressures on NHS finances, with a quarter of NHS trust finance directors surveyed for the report expecting to overspend their budgets this year.
Analysis of the data collected for the report shows that the nursing workforce increased by almost 9,000 over the past six months to nearly 315,000 – the highest on record. This underlines the difficult choice facing hospitals: whether to balance the books or maintain quality of services, with many choosing to recruit more nurses despite their budgets being stretched to the limit.
The report warns that cracks are beginning to appear in NHS performance as a result of the growing financial pressures and rising demand for services. Although the A&E waiting time target was just met over the quarter (April – June) once all types of unit are included, hospitals with major A&E departments have now missed the target for 51 weeks in a row. Meanwhile, more than 3 million people had been waiting at least 18 weeks for hospital treatment at the end of the quarter, the highest number since 2008.
The key findings from this quarter's report include:
The report also finds worrying inconsistencies between the plans of hospitals and clinical commissioning groups (CCGs). While 55 per cent of CCGs surveyed are planning a reduction in emergency admissions, only 8 per cent of NHS trust finance directors are working on this basis. CCGs are also forecasting less elective activity, with only 32 per cent expecting an increase in planned treatment compared to 69 per cent of trust finance directors.
John Appleby, Chief Economist at The King's Fund, said: ‘Our latest quarterly report paints a picture of a service under huge pressure, with cracks beginning to appear in NHS performance. It once again underlines the need for new funding if services are to be maintained. The increase in the nursing workforce signals a very welcome commitment to improving care, although it remains to be seen whether hospitals will be able to sustain current staffing levels when money becomes tighter later in the year. The disparity in the plans of providers and commissioners points to a worrying mismatch between activity and funding, which could have serious financial consequences.’
How is the NHS performing? is the latest of The King’s Fund’s regular quarterly monitoring reports. For further information or to request an interview with John Appleby, please contact the Press and Public Affairs team on 020 7307 2585 (07584 146035 if calling out of hours).
This quarter's survey was carried out online between 23 May and 6 June 2014. Of 248 NHS trust finance directors contacted, 73 responded. We contacted 206 CCG finance leads, of whom 47 responded. Between them, these finance leads covered 61 CCGs.
The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.