News / Trusts’ productivity improves

NHS trusts in England are treating more patients at lower cost but primary care trusts have yet to move more care into the community, according to the Audit Commission.

In an analysis of how NHS money has been spent, whether services were moving out of hospitals and hospital efficiency, the commission said trusts were increasing productivity and reducing unit costs but the focus was now turning to PCTs.

‘Productivity and quality are the twin foundations on which the NHS will face and weather pressures on public spending in the next few years. Hospitals are starting to become more efficient. But to reduce pressures and ease finances, the drive from primary care trusts towards providing equally good, if not better, care in the community needs to increase significantly,’ said commission head of health Andy McKeon.

The analysis, set out in the More for less briefing, suggests PCTs made little or no inroad in 2008/09 into transferring care from hospitals to the community – outpatient levels grew by 8%, inpatients by 4%.

Latest figures show that, allowing for inflation, trusts’ 2007/08 costs were down by 3.7% on two years before, partly due to a big rise in the number of less complex cases. Trusts would come under more pressure to cut costs – in 2009/10’s first quarter, acute and specialist trusts faced a 4.3% rise in inpatient care paid for under payment by results but only a 2% tariff uplift.

NHS Confederation director of policy Nigel Edwards welcomed the improved productivity but warned that moving care into the community had consequences.

‘Given the NHS’s finite resources, creating savings through increased community services would have to be offset by reduced hospital capacity. Communities will have to be fully informed and involved in these decisions if we are not to find repeated opposition against changes that would bring about genuine improvement to patient care,’ he said.