Chancellor urged to act on H2 funding and capital approval

In a letter to the chancellor, new confederation chief executive Matthew Taylor said the NHS could make significant in-roads into the elective care backlog under the right circumstances. He added that the funding and efficiency targets for the second six months of 2021/22 have not been published, leaving trusts uncertain over the employment of healthcare professionals and unable to plan beyond 12-month fixed-term contracts.

This had a knock-on effect on patients waiting for surgery, as trusts did not know whether to employ more staff and increase theatre capacity – with associated financial risks – or to stay within current budgets and face spiralling waiting lists. Discharge to assess funding is due to end in October, potentially creating bottlenecks in hospitals.

The letter added that trusts needed faster access to capital funding to expand their elective capacity, make A&E departments large enough to allow for social distancing, ensure Covid safety, and prepare for the expected surge in flu cases this winter.

However, trusts have told the confederation that they are not able to access the capital funds they need, or that it takes too long to receive and bureaucratic hurdles are too large.

Capital funding should be ‘front and centre’ in the next spending review, Mr Taylor insisted. But he added that in the short term NHS England and NHS Improvement, backed by the Treasury and the Department of Health and Social Care, must issue clear guidance on the approval process to ensure trusts and health systems can access capital quickly.

Mr Taylor said: ‘Given extra investment and much easier access to capital funding, the health service can continue to get more patients back through its doors and really start to ramp up how many people it sees and treats. But crucially to be able to do this effectively the bureaucratic barriers preventing healthcare leaders from quickly securing existing funding must be removed.

‘Healthcare leaders also desperately require clarity on how much money they will have to spend after the summer. Without it they are being placed in a truly impossible position.’