The NHS in England met its target of delivering £5.8 billion-worth of Quality, Innovation, Productivity and Prevention (QIPP) efficiency savings during 2011/12, writes Service chief executive Sir David Nicholson, in his latest annual report.
The 2011/12 report goes on to note that other NHS achievements during the year include: – infection rates at their lowest levels since mandatory surveillance was introduced; – lowest-ever level of patients waiting more than 18 months for their treatment to start, with over 90% of admitted and 95% of non-admitted patients starting treatment within 18 weeks of referral; – all ambulance trusts meeting their category A8 performance measure (resulting in an emergency response arriving within eight minutes) for the first time since Call Connect was introduced in 2008; and – all performance measures met on A&E, cancer care, dentistry and waiting times.
The report also reveals progress in the goal of reducing unplanned emergency admissions to hospital, with 1% fewer GP referrals made than in 2010/11, and growth in elective activity (admissions) at 3.6%, the same as in the previous year. This suggests that the NHS is starting to treat more people in the most appropriate setting and preventing unnecessary admission, it says.
Emergency admissions were also down 1% for the year, with A&E attendances up 1.8% and urgent and emergency ambulance journeys per day dropping 1.6%. This would indicate, in the context of a continuing increase in the demand for acute services, that emergency admissions are being avoided or treated in more appropriate settings, says the report.
Discussing the progress of the QIPP agenda during 2011/12, Sir David writes that, during quarter two (July-September 2012) “we began to see greater involvement from emerging clinical commissioning groups [CCGs] in the ownership and delivery of QIPP in their local areas, in collaboration with existing Primary Care Trusts [PCTs].”
“In quarter three the NHS was broadly on track to deliver the QIPP savings, with year-to-date savings of £3.9 billion. Local QIPP programmes were emerging and transformational change was demonstrating positive progress,” he notes.
And for quarter four (January-March 2012), the Service made £1.9 billion in QIPP savings, bringing the total for the year to the forecast level of £5.8 billion, which Sir David describes as “a superb achievement” which is “providing a firm foundation of sustained delivery in 2012/13 and beyond.”
At final accounts, Strategic Health Authorities (SHAs) and PCTs are reporting an overall year-end surplus of £1,583 million, which represents 1.6% of total NHS revenue resources and is an improvement on the £1,498 million surplus reported for quarter three of the year, says the report. This surplus will be carried forward into 2012/13.
Also, NHS trusts (excluding foundation trusts) are reporting an overall year-end surplus of £45 million in their final accounts for the year, having reached a £30 million surplus at quarter three.
Looking back at the events of 2011/12, Sir David comments: “I certainly can’t remember another time in my three decades as an NHS manager when we have faced so many complex challenges on so many fronts at once.” Not only was the Service required to start delivering the QIPP efficiency savings – “releasing up to £20 billion to re-invest in quality – we did this against a backdrop of intense political and public debate about reform,” he says.
And looking to 2012/13, he emphasises that “the demands of an ageing population and increased costs owing to developments in drugs and advancing medical technologies present challenging financial conditions in a constrained economic climate. All parts of the NHS will need to take bold, long-term measures to rise to this challenge and deliver sustainable improvement in 2012/13.”
“This is the year when we will need to start to work out how we are going to respond to the Chancellor’s Autumn Statement, which confirmed that restrictions on public spending are likely to remain in place for a long time to come. QIPP is therefore no longer a strategy for managing the NHS up to 2015, it is going to have to become the way we manage the service for the foreseeable future,” he cautions.
