HFMA South West Conference National Finance Update

Transcript:HFMA South West Conference National Finance Update:
HFMA South West Conference National Finance Update Simon Currie NHSE Director of Financial Oversight & Delivery 2023/24 financial position 23/24 revenue outturn Pressures/issues we had to absorb: High headcount growth High inflation Industrial action ERF earnings VPAS scheme close Specialised high-cost drugs Significant pay increases New depreciation funding regime PFI PDC dividend windfall Interaction of depreciation and IFRS16 changes 23/24 System Performance Workforce growth Profile of system risk in 23/24 Planned £2.3bn deficit for 24/25 To ‘buy out’ all overspends at level of the highest would cost a further £7.9bn If we distributed the deficit funding on a fair shares basis, we would still have a further £800m of overspends to cover Incentives and disincentives Designed to rebalance systems to fair shares position (over two years) Calculated a ‘fair share’ of the total £2.3bn deficit Took the difference between this & the system CT Produced three distinct groups: Deficit CT above fair share – capital deductions & future year repayments Deficit CT below fair share – no deductions, no bonuses Breakeven CT – capital bonus this year, capital and revenue next year Investigation & Intervention Process Implemented for the first time this year Currently 12 systems being supported Designed for short, sharp intervention to reduce spend rate Focus on plan delivery, not longer term recovery Requires very swift mobilisation External consultancy support for delivery Supported by NHSE-appointed senior leader I&I Key Observations Workforce controls Follow through of workforce issues Involvement of ops, medical, nursing, HR Non-pay controls CHC review processes Demand management incl. patient decision aids Role of the ICB not always clearly understood Lack of focus on actions and delivery Learning being shared via the ‘Finance playbook’ Diagnosis Plan Improvement tools Transition Highlights areas considered highest priority. Timing of diagnosis and improvement will vary depending on organisational circumstances. Likely overlap between diagnosis, plan and improvement phases with opportunity for continuous improvement cycle. Finance playbook at a glance The full finance playbook and supporting tools can be found in the finance section of the National Recovery Support NHS Futures site: National Recovery Support - FutureNHS Collaboration Platform What’s coming next? Darzi review published already, 10 year plan to follow Re-engage staff and re-empower patients Lock in the shift of care closer to home Simplify and innovate care delivery for a neighbourhood NHS Drive productivity in hospitals Tilt towards technology Contribute to the nation’s prosperity Reform to make the structure deliver