“This report is an important summary of where the NHS stands three years into an unprecedented period of financial challenges. Overall, our research and analysis support the Committee’s conclusions.
Better joined-up care may well improve the experience and quality of life of patients, but it probably won’t create savings, certainly not in the short term Andy McKeon, Chief Executive, Nuffield Trust
“The NHS has met its headline targets, but it has relied on relatively straightforward ways to do so, cutting the prices paid to hospitals and freezing wages. These policies will not be sustainable over the next few years, and won’t provide enough savings to bridge the £30 billion funding gap which NHS England expects to see by 2021.
“The report perhaps puts too much emphasis on the importance of ‘transformative change’ involving shifting funds and patients out of hospitals and towards social and community care. Better joined-up care may well improve the experience and quality of life of patients, but it probably won’t create savings, certainly not in the short term.
“It has been suggested that changes like these will save money by keeping people out of hospitals. But our research on many ‘integrated care’ initiatives designed to achieve this has found no evidence of lower costs.
“The report’s argument for ring-fencing social care funding must be seriously addressed – deep cuts to local authority budgets mean financial pressure here is intense. Surveys suggest councils are responding by changing their eligibility policies, so that adults facing significant but not overwhelming problems with everyday tasks increasingly cannot get help to pay for care.
“Our researchers are looking at demonstrating the impact of these cuts in social care, which are set to continue.
“Looking ahead, a major challenge for the NHS, closely linked to social care cuts, will be finding the money to transfer into the ‘Better Care Fund’ to create more integrated services.
“Coming on top of existing savings requirements, this will make 2015/16 a very difficult year for the health service. Even if the NHS succeeds in doing this, the major risk is that the money will be needed mainly to prop up existing services, rather than create new ones’’.