Briefing / NHS financial temperature check

The key messages are:
• Almost all finance directors who responded to the survey rate the financial challenge in 2023/24 between eight and 10, on a scale where one is achievable and 10 is impossible.
• The ratings for the current financial year are lower – more finance directors expect to meet their own organisational plan in year. However, they are less certain that system wide plans will be achieved.
• Organisations are taking action as a result of these concerns. When asked what national bodies could do to help, the key messages were to be transparent about available funding and realistic about what can be achieved with that funding.
• There is still concern about achieving various targets in 2022/23:
• some organisations rate more than half of their efficiency plans as high risk
• all except one respondent did not expect to achieve the elective recovery target.
• Actions taken to meet efficiency targets are varied but the overall theme of responses was the reintroduction of pre-pandemic financial governance arrangements and additional grip and control.
• Finance directors are concerned that longer term measures in relation to prevention, population health and health inequalities will be delayed as resources are spent on more immediate concerns.
• Almost half of finance directors were concerned that quality will be impacted by financial constraints. This is already being seen in longer waiting times and restricted access to services.
• Capital programmes remain a concern, particular issues raised include the lack of clarity as to when permission to spend capital money will be received and the possibility of the release of capital funds in early 2023 that will have to be spent by the end of the financial year.
• Working on a system wide basis to resolve issues was mentioned by respondents, but they are also aware that there needs to be a cultural shift to working on this basis and there is still silo working in some places.