News / Demand threat to finances

In its latest quarterly review, the fund said demand was soaring –it said in the first quarter of 2016/17 there were an additional 54,000 A&E attendances and 14,200 emergency admissions compared with the same time last year. Almost 10% of patients waited longer than the four-hour target in A&E, while there were 6,100 patients in hospital who were medically fit to leave but awaiting discharge. This was the highest figure since collection of the data began and a 22% increase on June 2015. The elective waiting list continued to grow with an estimated 3.8 million patients, the highest level since December 2007.

The figures were supported by performance data from NHS England, also published this week. The figures, covering July this year, show standards were not met in A&E, two of the six cancer targets, referral to treatment and diagnostic tests. A&E attendances were 6.3% higher than July 2015, with 90% of patients admitted, discharged or transferred within four hours of arrival (the standard is 95%). Emergency admissions were 3.4% higher than in July 2015.

Amid the rise in activity, and despite actions to reduce spending, many finance directors were pessimistic about the prospects for 2016/17. In the King’s Fund quarterly survey of finance directors, 47% forecast a year-end deficit, while only a third were confident of meeting the control totals they have agreed with NHS Improvement.

Commissioner confidence has declined, with twice as many clinical commissioning group chief finance officers predicting a year-end deficit than at this time last year.

King’s Fund policy director Richard Murray said it was striking how key targets were being missed all year round. ‘This reflects the impossible task of continuing to meet rising demand for services and maintain standards of care within current funding constraints,’ he said.

‘While new investment and actions taken to tackle overspending have reduced deficits among NHS providers in the first quarter of the year, it would be a mistake to suggest that the financial pressures which have engulfed the NHS have eased. Unless more is done to tackle rising demand, the ideas emerging from sustainability and transformation plans about cutting beds and reconfiguring hospitals will look even more unrealistic.’

Commenting on the King’s Fund report and the latest performance figures, NHS Providers head of analysis Siva Anandaciva (right) said: ‘We need to be honest with the public about the consequences of the longest and deepest financial squeeze in NHS history. The NHS will be performing heroically well to just maintain existing standards of care in the next 12 months. The real fear is that we lose all the progress achieved in recent decades to improve both the quality of care and how long people have to wait for it.’