An official report has found that more leading NHS Trusts are suffering financial difficulties and expect the situation to get worse over the next year.
Out of the Foundation Trusts surveyed, 21 which is an increase of 8 on last year, stated “that they are likely to experience cash problems over the next year”. In addition the survey also indicated that 16 Trusts were at risk of failing to meet key targets relating to treatment of patients on time, with a similar number also likely to breech A&E waiting time limits. The latest survey highlights the continued pressure the NHS is coming under in a bid to meet the Government’s target of £20 billion in savings by 2015. More and more Primary Care Trusts are now failing to meet the spending cuts.
Monitor – the regulator for the semi-independent Foundation Trust sector, has warned hospitals not to fix their financial problems by cutting back on patient care. Monitor’s chairman, Dr David Bennett stated “The challenge of reducing costs must be met, but it is essential that good patient care is at the heart of this. This year we have put extra focus on identifying the potential risks to quality that could result from each trust’s plan. The evidence we have seen in Foundation Trusts’ plans suggests they are not planning to make savings by treating fewer patients or reducing the level of care for patients. Instead they plan to make them through more efficient working on the front line and by reducing administrative or clerical costs.”
Monitor required all 137 Foundation Trusts to submit their current three-year plans and following analysis of these stated “they face their most challenging time. They face lower margins as they take over contracts to run community services and as their operating expenses increase. Managers must also make efficiency savings of 4.4 per cent and plan to do so mainly by cutting staff costs.”
With NHS hospitals across the UK looking at ways to cut back on spending, patient care is likely to suffer as some hospitals could look at reducing the number of staff such as nurse jobs, community nurse jobs, midwifery nurse jobs and support staff.
It is anticipated that 11 NHS Trusts will have received Monitor’s highest financial risk rating by the end of the year, an increase from last years’ total of 4, in addition a further 10 NHS Trusts are likely to break the economic rules guaranteeing them FT status at some point during the financial year.
Following analysis of their balance sheets it suggests that expenditure on drugs is likely to increase, alongside the cost of building new sites using Private Finance Initiative deals.
The current Government system requires NHS Trusts to see patients referred by GP’s, within 18 weeks. Worryingly 16 NHS Trusts have already indicated that they are at risk of not meeting this target, with a similar number in fear of breaching the Government’s target relating to the superbug C. difficile.
Another statistic highlighted by the survey, showed that 14 NHS Trusts are likely to breach the target to see A&E patients within four hours, with this number only increasing with the onset of winter and the likely increase in admissions.
With the Government’s funding remaining flat and demands rising, the management bodies that pay for NHS patients’ treatment are also facing financial trouble. Over the next four years they must make efficiency savings of 4 per cent each year. However, a survey carried out recently indicated that for the current financial year, 59% were anticipating missing this target. Naturally this is likely to result in even more cuts next year, with health experts envisioning more pressure and the possibility of even more treatments being reduced or rationed.
A spokeswoman for the Department of Health, said, “Foundation Trusts have greater autonomy to innovate new ways of delivering health services – they are truly responsive to patients, not ministers.”
“But their freedom comes with responsibility and foundation trusts must demonstrate that they are improving outcomes for patients and managing their finances effectively as well as ensuring times are kept low.”
With news of more trusts predicting financial problems over the coming years, further cutbacks are likely to affect patient care and the morale of staff working within the NHS as budgets and staff are being cut.
One of the key concerns is how frontline services can be maintained as promised by the coalition government when such cutbacks are being implemented across the NHS. With increased demand on services, particularly in the winter months, this is only likely to cause more pressure on services.
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