HFMA NHS Financial Temperature Check Finance directors views on financial challenges facing the NHS: December 2014 Introduction Summarises results of HFMAs second NHS financial temperature check survey of NHS finance directors, published
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Presentation Transcript
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HFMA NHS Financial Temperature Check Finance directors’ views on financial challenges facing the NHS: December 2014<br>
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Introduction Summarises results of HFMA’s second NHS financial temperature check survey of NHS finance directors, published December 2014
Includes views of sample from all UK finance directors working in English commissioning and provider bodies (trusts, CCGs and area teams) and devolved nation NHS bodies
Survey collected views from 21 October to 4 November 2014
First briefing published June 2014<br>
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Response rate was high, covering nearly half of English trusts and 1 in 3 other bodies<br>
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Financial outlook<br>
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The financial position across the NHS is deteriorating, according to latest figures 55% of FTs were in deficit at quarter 2. Acute trusts represent the majority of the deficit
FTs reported a £254m deficit at 30 September 2014, compared with a planned net deficit of £59m
NHS trusts reported a £376m deficit as at 30 September 2014, compared with a planned net deficit of £317m
26 NHS trusts (27%) are forecasting a year-end deficit, 24 are acute trusts
CCGs forecast a year-end overspend of £21m. 21 CCGs are forecasting overspends against plan as at 30 September 2014<br>
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14/15 forecast positions are worse than 13/14 for many organisations and there is slippage from plan<br>
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The main drivers of commissioners’ year-end forecasts are increased acute care costs and unachievable savings<br>
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The main drivers of trusts’ year-end forecasts are increased costs and unachievable savings<br>
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Responses shows trusts’ pay costs are driven by high agency staff costs and increasing numbers of nursing and medical staff<br>
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The main cost pressures are around staff costs, increasing demand and continuing healthcare<br>
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Commissioners plan to use a range of mechanisms to deal with financial challenges<br>
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Providers intend to use a mixture of mechanisms to reduce costs and change the way services are provided<br>
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Providers and commissioners concerns about the financial health of their local economy are broadly similar *Not asked in June survey<br>
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Quality of services<br>
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What changes do you anticipate in the quality of patient services provided by your organisation?<br>
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Access to services and waiting times are considered most vulnerable aspects of quality<br>
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Integration and the better care fund<br>
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There is scepticism about the benefits of integration and the better care fund<br>
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Finance directors have doubts the better care fund will bring financial benefits<br>
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Finance directors are not confident planned benefits of better care fund will be achieved<br>
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System leadership<br>
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Finance directors have different views about who provides the system leadership<br>
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Five year plans<br>
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Finance directors are not confident about the assumptions underpinning years 3 to 5 of their five year plans.<br>
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Not all plans have been fully agreed by commissioners and providers<br>
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Confidence in the achievability of the five year plans is low<br>
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Confidence is higher for the first 2 years of the plans<br>
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What can be done to help the financial pressures?<br>
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What do finance directors think needs to change? Finance directors outlined actions to help reduce financial pressure:
Faster progress on service transformation
More realistic financial settlement and efficiency requirement
Clear system leadership
Improved national workforce planning
Caution around better care fund implementation
Changes to the national payment system<br>
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What are the HFMA’s views? More funding is required to enable the transformation of the NHS
Faster progress on large transformation schemes is essential and requires system leadership
National workforce planning and training requires improvement
Rapid progress is needed on the reform of payment systems in order to support new models of care<br>
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Four nations<br>
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In common with the English NHS, NHS finances in Scotland, Wales and Northern Ireland are deteriorating<br>
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The year-end financial position will be worse in many organisations compared with 2013/14 and 2014/15 plans<br>
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Finance directors plan to use a range of mechanisms to deal with financial challenges<br>
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The majority of finance directors expect quality to stay the same, or improve<br>
