A significant portion of NHS finance directors believe that the quality of patient care will deteriorate in 2016/17 while many are questioning the likely success of financial support measures, according to findings of the latest NHS Financial Temperature Check survey.
More than one in five finance directors – 21 percent of Clinical Commissioning Group (CCG) chief financial officers and 23 percent of trust finance directors – believes the quality of patient services will take a downturn this year, and a one third of provider trusts are expecting it to decline further.
Waiting times (76 percent), access to services (69 percent) and enabling a range of services being offered (61 percent) were cited as being the most vulnerable aspects of patient care.
For the third year in a row, the financial performance of the NHS worsened, with both NHS Trusts and NHS Foundation Trusts reporting a deficit and CCGs also reporting an overspend for the first time 2015/16.
Twenty-eight percent of organisations reported a worse year-end position than anticipated at the beginning of 2015/16, leading to a combined trust deficit of £2.45 billion at the end of the financial year, compared to the expected shortfall of £1.99 billion.
Agency staff (51 percent), the under-achievement of savings plans (33 percent) and an increase in fines, challenges and deductions (23 percent), were blamed for the worse than expected result.
Finance directors are also questioning the ability of their organisations to deliver the control totals set by NHS Improvement, with 60 percent of those signed up expecting to meet the conditions set, while just 16 percent are very or quite confident that organisations in their Sustainability and Transformation Plan (STP) footprint can deliver a connected strategic plan, highlighting the lack of confidence that measures to cut spending and improve efficiency can be delivered.
Going forward, the Healthcare Financial Management Association (HFMA)'s report notes that planned savings for 2016/17 are ambitious, and the survey found that two-thirds (67 percent) of CCGs and almost half (48 percent) of trust respondents reported a high degree of risk associated with achieving their organisation's financial plans for the year, with the biggest risks identified being dwindling cost savings (78 percent), agency staff spend (72 percent), the impact of social care financial constraints (56 percent) and increasing demand (52 percent).
"The scale of the NHS deficit continues to reach unparalleled levels, and it is unlikely the provider position will be in balance at the end of 2016/17, as originally planned," noted Paul Briddock, Director of Policy at HFMA.
"Fears around the impact the current financial turmoil in the NHS could have on quality are also a real cause for concern and we may start to see more of these predictions come true in the year ahead. To avoid this, there is a need for NHS organisations to work together to address these financial and operational pressures by the efficient redesign of services and to put an end to the shifting of financial problems between sectors".