"So far the NHS is meeting the
challenge of maintaining strong finances in a period of austerity.
It is clear, however, that parts of the service are under
strain.
"For value for money to be delivered in future,
two things are required: firstly, careful management of the risks
created by transition to a new commissioning model; and, secondly a
coherent and transparent financial support mechanism which outlines
when trusts should be supported, or allowed to
fail."
Amyas Morse, head of the National Audit Office, 5
July 2012
A report published today by the National Audit
Office has found that, although in 2011-12 there was a surplus of
£2.1 billion across the NHS as a whole, there is also some
financial distress, particularly in some hospital trusts.
According to today’s report, in 2011-12 there
was a large gap between the strongest and weakest NHS
organisations. The difference was particularly marked in
London.
In the long term, achieving financially
sustainable healthcare is likely to mean changes to how and where
people access services, and some local commissioners are already
consulting on and developing plans to do this. At the moment,
however, in order to break even, some organisations have relied on
additional financial support from within the NHS. According to
today’s report, 10 NHS trusts, 21 NHS foundation trusts, and three
Primary Care Trusts (PCTs) reported a combined deficit of £356
million. The NAO estimates, based on a census of PCTs, that without
direct financial support, a further 15 NHS trusts and seven PCTs
may have reported deficits.
There are four foundation trusts and 17 NHS
trusts which between 2006-07 and 2011-12 needed injections of
working capital from the Department of Health totalling £1 billion.
Among these, between 2006-07 and 2011-12, the Department issued a
total of £356 million to South London Healthcare NHS Trust and its
predecessor bodies, and £195 million to Barking, Havering and
Redbridge University Hospitals NHS Trust. The Department
anticipates that NHS trusts and NHS foundation trusts are likely to
need around £300 million more public dividend capital in
2012-13.
Of the PCTs responding to a National Audit
Office census, 51 per cent said they were concerned about the
financial sustainability of their healthcare providers. Previously,
PCTs and Strategic Health Authorities (SHAs) have been able to
support otherwise weak providers. It is not yet clear whether
clinical commissioning groups and the NHS Commissioning Board will
agree to provide financial support to providers, in the way that
SHAs and PCTs have done.
The NAO concludes that it is hard to see how
continuing to give financial support to organisations in difficulty
will be a sustainable way of reconciling growing demand for
healthcare with the size of efficiency gains required within the
NHS. Without major change for some providers, the financial
pressure on them will only get more severe.
source: nao.org.uk/
