Comment / What we need to know about NHS funding flows

The NHS will celebrate its 70th birthday this July.  On such a landmark occasion, there is lots to celebrate and feel proud of.  But the service also faces a series of formidable and well known challenges – with costs rising and budgets and financial incentives failing to keep pace.  

Winter pressures in the NHS have prompted a binary discussion over the airwaves of whether the NHS has enough funding.  Without a doubt, a clear, long-term, sensible funding settlement is needed for health and care – but something else is needed too.

The funding that flows around our health and social care system needs to incentivise behaviours that deliver the health outcomes that citizens need.  I mean the behaviours of all those with a stake in the system – clinicians and those delivering care on the front line, those managing the NHS and social care, and the public too including both the sick and the well.

The current system of funding flows was designed 15 years ago based on two main policy objectives: to bring down waiting lists by incentivising greater throughput from providers and bringing new capacity into the market; and to increase autonomy from the centre and create an environment for internally-driven efficiency.

We are now in very different times, with a system facing different pressures and priorities.

This is why PwC is working with the HFMA to examine the current funding flows within the NHS and how they could be changed to support the new ways of working across systems and ultimately to incentivise better outcomes.  

We would like your help. We have been holding a series of events, interviews and discussions across England to explore the potential changes that are needed to encourage collaboration and incentivise different types of outcomes. We would like to open out this conversation to everyone working in health and social care to get your perspectives on what the way forward should look like. 

Finance managers are in a prime position to understand what’s working and what isn’t within the system as it stands – and what would support the development of an integrated health and care system. So please complete this short survey and help us make recommendations about how the funding arrangements need to change to help the NHS make its centenary.

All responses will be treated confidentially and the survey should take no longer than 10 minutes to complete. If you have any queries please contact [email protected] or [email protected].

For more on PwC’s previous research on redrawing the health and social care architecture visit this research hub.

To access the survey, click here.

The funding flows research steering group is led by former health secretary the Rt Hon Alan Milburn, who is chair of the PwC Health Industries Oversight Board. Mr Milburn will address the HFMA Provider Finance Faculty’s directors’ forum on 16 May