Securing the future financial sustainability of the NHS


Book Description

Although in 2011-12 there was a surplus of £2.1 billion across the NHS as a whole, there is also some financial distress, particularly in some hospital trusts. In the long term, achieving financially sustainable healthcare is likely to mean changes to how and where people access services, and some local commissioners are already consulting on and developing plans to do this. Currently, some organisations have relied on additional financial support from within the NHS. 10 NHS trusts, 21 NHS foundation trusts, and three Primary Care Trusts (PCTs) have reported a combined deficit of £356 million. There are four foundation trusts and 17 NHS trusts which between 2006-07 and 2011-12 needed injections of working capital from the Department of Health totalling £1 billion. The Department anticipates that NHS trusts and NHS foundation trusts are likely to need around £300 million more public dividend capital in 2012-13. 51 per cent of PCTs reported concern about the financial sustainability of their healthcare providers. Previously, PCTs and Strategic Health Authorities (SHAs) have been able to support otherwise weak providers. It is not yet clear whether clinical commissioning groups and the NHS Commissioning Board will agree to provide financial support to providers in this way. The NAO concludes that it is hard to see how continuing to give financial support to organisations in difficulty will be a sustainable way of reconciling growing demand for healthcare with the size of efficiency gains required within the NHS




Department of Health


Book Description

Ensuring a viable financial future for healthcare providers is vital if the public are to have confidence in the delivery of their local services. In 2011-12 NHS organisations in England reported a combined overall surplus of £2.1 billion. There were, however, significant variations in performance between NHS bodies. 377 NHS organisations reported a surplus in the year, but 10 NHS trusts, 21 NHS foundation trusts and three Primary Care Trusts (PCTs) reported a combined deficit of £356 million. Eleven NHS foundation trusts would not have made foundation trust status today given their financial performance, and there is a real concern that some organisations will fail. The very difficult financial situation of some NHS bodies is particularly marked in London, where two trusts reported a combined deficit of £115 million. The Department placed one of these, South London Healthcare NHS Trust, in special administration in July 2012. Also a number of trusts in financial difficulty have PFI contracts with fixed annual charges that are so high the trusts cannot break even. The Department was unable to spell out to the Committee a clear plan to achieve financial sustainability and a clear strategy for dealing with financial failure in individual trusts. The Department could not provide adequate reassurances that financial problems would not damage either the quality of care or equality of access to all citizens, wherever they live.




NHS SOS


Book Description

An exposé of the back-door deals and negligence that threaten to destroy the NHS – and a 10-step manifesto for saving it The Coalition Government passed into law an unprecedented assault on the NHS. Doctors, unions, the media, even politicians who claimed to be stalwart defenders failed to protect it. Now the effect of those devastating reforms are beginning to be felt by patients – but we can still save our country’s most valued institution if we take lessons from this terrible betrayal and act on them. Contributors to this eye-opening dissection include Dr Jacky Davis, Oliver Huitson, Dr John Lister, Stewart Player, Prof. Allyson Pollock, David Price, Prof. Raymond Tallis, Dr Charled West and Dr David Wrigley. Proceeds from the profits of this book will go to Keep Our NHS Public (www.keepournhspublic.com).




Public Expenditure on Health and Care Services


Book Description

This report states that the values of the NHS will only be reflected in practice if NHS and social care services are 're-imagined'. The care provided by the health and social care system will break down if quicker progress is not made to develop more integrated health and social care services which focus on meeting the needs of individual patients. It is unlikely that public expenditure on health and social care services will increase significantly in the foreseeable future. This means that the only way to sustain or improve present service levels in the NHS will be to focus on a transformation of care through genuine and sustained service integration. There must be a much more joined up approach to commissioning health and care services. On other issues the Health Committee also concludes: measures currently being used to respond to the Nicholson Challenge too often represent short-term fixes rather than the sustainable long-term service transformations; changes in tariff payments within the NHS do not constitute ’efficiency savings' - they are simply internal transfers; under-spending against budget of money allocated to the NHS has attracted adverse comment and the MPs call for a general review of the operation of Treasury rules; the NHS will not be able to rely on the present rate of paybill savings once the present restraints on public sector pay are relaxed in April 2013




Peterborough and Stamford Hospitals NHS Foundation Trust


Book Description

The board of Peterborough and Stamford NHS Trust failed to recognize in 2007 that a PFI scheme to build a new hospital, Peterborough City Hospital, would place considerable strain on its finances for years to come. The then board compounded the decision to proceed with the scheme, which it could not afford, with a failure to monitor other changes affecting its income and costs between 2007 and 2011. In 2011-12, the in-year deficit was £46 million and the Trust is predicting an in-year deficit of more than £50 million in 2012-13. Monitor, the regulator of foundation trusts, raised well-founded concerns about the scheme's affordability with the Trust Board and the Department, however neither addressed these concerns fully before approval of the business case. Despite its earlier views, the regulator rated the Trust as a very low financial risk, reflecting its reported financial position but this risk rating did not reflect the future impact of the PFI development. Monitor had a number of opportunities to intervene before finally placing the Trust in breach of its terms in October 2011 but concluded that an intervention would not necessarily improve or change the outcome positively. The level of healthcare undertaken by the Trust is also greater than envisaged in the PFI business case, which assumed a 14 per cent drop in outpatient activity whereas this increased by 21 per cent. In addition, NHS Peterborough, the Trust's main commissioner, which has been in financial difficulty itself, has used national and local performance indicators to withhold payments for activity undertaken by the Trust




The Politics of Public Sector Reform


Book Description

The first comprehensive 'bird's eye' account of public sector reform supported by references from over 400 official sources, this book is an invaluable guide to all those in the public, private and voluntary sectors grappling with the twin challenges of managing public spending austerity and the pressure in response to transform public services.




The New Politics of the NHS, Seventh Edition


Book Description

The New Politics of the NHS has become established over 30 years as the key overview of the NHS, its processes and paths of influence. The seventh edition remains a clear, easy-to-read guide to often complex debates. It encompasses both the background of the evolution of the NHS since its foundation, and a completely up-to-date picture of its prese




Public–Private Partnerships and the Law


Book Description

This timely book examines the legal regulation of Public_Private Partnerships (PPPs) and provides a systematic overview of PPPs and their functions. It covers both the contractual relationships between public and private actors and the relationships be




HC 1141 - The Work of the Committee of Public Accounts 2010-15


Book Description

This report summarises the key areas of the Committee's work over the past five years. It draws out the areas where progress has been made and where their successors might wish to press in future. The Committee has assiduously followed the taxpayer's pound wherever it was spent. Since 2010 they held 276 evidence sessions and published 244 unanimous reports to hold government to account for its performance. 88% of their recommendations were accepted by departments. In many cases they successfully secured substantial changes, for example with the once secret tax avoidance industry. They secured consensus from government and from industry that private providers of public services do have a duty of care to the taxpayer, and in pushing the protection of whistleblowers further up the agenda of all government departments. By drawing attention to mistakes in the Department for Transport's procurement of the West Coast Mainline, more recent procurements for Crossrail, Thameslink and Intercity Express have all benefited from more expert advice and a more appropriate level of challenge from senior staff. After discovery in 2012-13 that 63% of calls to government call centres were to higher rate telephone numbers, the Government accepted our recommendation that telephone lines serving vulnerable and low income groups never be charged above the geographic rate and that 03 numbers should be available for all government telephone lines. They also secured a commitment to close large mental health hospitals.




House of Commons: Sessional Returns - HC 1


Book Description

On cover and title page: House, committees of the whole House, general committees and select committees. On title page: Returns to orders of the House of Commons dated 14 May 2013 (the Chairman of Ways and Means)