NHS Leaders Facing “Drastic Measures” To Make Ends Meet Health leaders in England are calling on the next government to protect local NHS organisations from having to further cut staffing levels to make ends meet at a time when the needs of their patients are so high. In a survey of NHS leaders across trusts, integrated care boards (ICBs) and primary care in England, some local NHS organisations are already cutting or freezing posts to balance their books. They fear local services are trapped in a cycle of short-termism where immediate cuts to meet financial targets are having to be prioritised over long term plans to improve and transform local services. The survey was carried out during late April and early May – a time when the NHS has been coming to terms with the “flat” revenue settlement set in the Spring Budget. The NHS has been set an annual efficiency target of 2.2%, despite many organisations starting the financial year in a worse underlying state due to industrial action and other cost pressures. As the NHS Confederation survey shows, many local NHS organisations are facing much higher efficiency targets that will impact on their staffing levels. The rate of NHS productivity growth has averaged 0.9 per cent over the past 25 years, with the NHS often delivering higher productivity improvements than the wider economy. However, the NHS leaders responding to the survey said that they need, on average, to make efficiency savings of 6% in 2024/25, with local services facing targets ranging from 1.6% all the way up to 11%. Recently, the Institute for Fiscal Studies found that real-terms spending on the NHS had risen less quickly than was pledged at the last general election five years ago. This squeeze on NHS spending is likely to be compounded by the main political parties committing this week to no further tax increases, which the IFS say will further constrain spending on public services. In response to this, some health leaders are having to take “drastic measures” to balance the books, with cuts to agency spending, freezing vacancies and cuts to clinical and managerial and administrative staff the most effected. This is to cover what is estimated to be a larger projected deficit in the financial plans of local integrated care systems (ICS) than has been seen in recent years. This could lead to further cuts to capital and other budgets. Cuts to staff come at a time when the latest data shows there are over 100,000 vacancies across the NHS in England, including nearly 9,000 medical posts. This short-term risk to freeze or cut posts could be seen to go against the NHS Long Term Workforce Plan’s commitment to grow the NHS’s headcount so that it can meet the needs of patients and respond to rising demand. The main political parties appear to agree that the NHS must grow its workforce, yet without appropriate levels of funding locally that are matched to the efficiency asks of the NHS, many health leaders feel as though they have no…
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Just what is needed : 😖 NHS Funding Set to Dip in Coming Year, Ella Pickover, Press Association | 19 March 2024 The funding pot for the NHS in England is set to “decrease” in the next financial year, leading health commentators have warned. The Health Foundation said the budget for the health service – £164 billion – remains “flat”, but when changes to the population and inflation are taken into account it will be 1% lower in 2024/25 compared with the previous year. New analysis by the think tank also suggests the overall Department of Health and Social Care budget – £192 billion for 2024/25 – equates to an increase of 0.6% in real terms compared with 2023/24 and a real-terms reduction in funding compared with 2022/23. The analysis also suggests that other spending by the Department, including money for healthcare staff education and training and the public health grant, is due to face a 4.7% real-terms funding cut in 2024/25 compared with 2023/24. Hannah Rose Douglas, deputy director for the The Health Foundation’s Real (Research and Economic Analysis for the Long term) Centre, said: “While the additional funding for the #nhs in the recent spring Budget is welcome, when the impact of a growing and ageing population as well as inflation is taken into account, the value of the NHS England’s spending pot will decrease in value by 1% in 2024/25, compared to the previous year. “This underlines the challenges for the NHS to improve care when faced with these ongoing funding and demand pressures. “The Government’s plans to increase capital spending to boost NHS technology is a welcome and significant investment, although it won’t kick in until 2025/26, after the general election. “There is a long history of promises to spend more on NHS capital and technology, with budgets too often raided to pay for short-term pressures, so it’s essential that this money is spent as intended.” Commenting on the analysis, Patricia Marquis, director for England at the Royal College of Nursing - Company, said: “NHS budgets must take account of our ageing population and increasing demand. Failing to do so means stealth cuts for the NHS, which could have profound consequences for patient care. “At a time when there are chronic staff shortages, applications to nursing courses are collapsing, and long waits for treatment have become normalised, this choice to under-invest in the NHS cannot be justified. “This latest analysis comes as reports say local NHS trusts are under pressure to cut staffing numbers to make this year’s budget add up. Cutting NHS budgets, especially on education and training, will push more nursing staff out of the health service and have an impact on the quality of care. “The NHS is in crisis and deserves better than a Government sitting on its hands. The Health Secretary must urgently address why nursing staff should accept being asked to do more with less yet again.”. #nursing #nurses
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Working for Thriving. For the personal and structural change needed for us to live our best possible lives.
Scotland's NHS cannot meet growing demand, warns watchdog https://lnkd.in/ehY_2WJE Stephen Boyle Audit Scotland "annual report ... NHS ... facing soaring costs, patients were waiting longer to be seen and there were not enough staff." "financial pressures on the NHS and, without reform, its longer-term affordability". "Without change, there is a risk Scotland's NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services." "investment in measures that address the causes of ill-health, reducing long-term demand on the NHS." Problems include delayed discharge, ambulance crews waiting at hospitals and patient safety. Another story that shows why #prevention and #proactive #services are so important. We have got to identify those who need help and support them before their health suffers and problems are hard, and expensive to treat. It is about #structures and #situations and #behaviours and needs #lifestyle change and #regulation. We know what needs to happen #eatwell #exercise #sleep #mindsets #mindfulness and issues with #vapes #alcohol #tobacco #ultraprocessedfoods and more, But we need to turn knowledge into action. Behaviour change can seem very cheap, we just do something different, but, it often does not happen on its own, it can be hard, need to be initiated, and supported, and that means investment. People need the right help from online support and apps, through groups., to 1:1 support . We need to invest in these services to reduce demand and save at the frontline. We need to change the culture and quickly because increased public spending by any party seems unlikely. And if we can’t spend and tax our way out of this we need behaviour change and regulation of health harms to tackle the causes of ill-health to reduce demand. And, as for structural change, it takes time.... This is not just about the NHS, #proactive services and #prevention is needed across #publicservices with problems costing individuals #society and #taxpayers. The good news is that there are a lot of free resources out there to help people make positive changes. We can use them to build personalised digital support and dashboards to help people thrive. And there are models to identify and help vulnerable people, connecting them with the public, private and voluntary, services, groups and 1:1 support that they need. See the SAVVI process #vulnerability https://lnkd.in/eRSJpCSC and my rough attempt at collating resources for wellbeing and thriving https://lnkd.in/e7vA6Ep2 Shelley Heckman Andrew Humphreys iNetwork Paul Wright - FFPH - FRSPH Andy Milne Tom Morton Ivan Beckley, MD Micha Kämpfer Ashleigh Henderson Felicia Szloboda Audrey Michie, FIPM Gregor Smith Karen Duffy Geoff Huggins Suraj Kika Kate Smethills Nick McCarthy Brian McNicoll Kirsteen Donachie Ben Jones Andrew Howe Cornilius Chikwama
Scotland's NHS cannot meet growing demand, warns watchdog
bbc.co.uk
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With news that the NHS is due to hit a deficit of £4.9 billion by March 2024, the future of the service is looking bleak. After requests for increased funding to cover increased costs due to strikes were denied by the Government, and a sharp increase in the cost of electricity and essential supplies, the service has hit a financial wall. With the Government refusing to increase funding to match the rate of spending, and with no decrease in spending in sight, the service is forced to pause investments in cost-saving measures, and instead pour money into day-to-day costs to stay afloat. Staffing is one of the key drivers of overspend, with the NHS having spent £3.2 billion on agency nursing staff from 2020-2022 – enough to have paid the salaries of 30,956 FTE nurses. To reduce overall spending, improve continuity of care, and staff retention, the NHS and the Government need to increase investment in permanent, FTE staff. https://lnkd.in/e9ZPQYR5 #NHS #NHSWorkforce #NHSRecruitment #NHSCareer
Local NHS bodies on track to spend £4.9bn more than planned, exclusive data shows
news.sky.com
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Government Reaping Result Of ‘Not Listening To NHS Staff’ As Public Survey Shows NHS Needs A New Direction, Says BMA In response to the latest British Social Attitudes survey published today by The King’s Fund and the Nuffield Trust Professor Phil Banfield, BMA chair of council, said: “After 14 years in office this government is reaping the result of not listening to NHS staff, and regrettably not a single doctor within the NHS would find these findings surprising. Despite our unwavering dedication to patient care, we find ourselves operating within a system that has been severely undermined, hindering our ability to deliver the high-quality care that both patients deserve, and we are eager to provide. This survey demonstrates that the public have not been taken in by the government’s attempts to blame everyone but themselves for the managed decline of the NHS. “The BMA has been shouting about chronic understaffing for years now – the NHS is providing services with a staggering almost 9000 doctors vacancies. In comparison, countries like Spain and Germany boast a third more doctors per person than England. This glaring disparity is ridiculous and as this survey found the public agree, with 51% of respondents saying, ‘increasing NHS staff is a top priority’. The BMA asked for a long-term workforce plan for decades to rectify this, and one only arrived last year - it’s just too little too late. “We know that across the country, patients are waiting far too long to see their GPs, and GPs are deeply frustrated about access issues. We’ve told the Government repeatedly what needs to be done to rectify this but instead of listening to us, it has starved general practice of resources. The recent practice contract baseline funding uplift of only £179m in the face of crippling rising costs and expenses is frankly an insult to my GP colleagues. Across the country, GP practices are closing – permanently. This survey shows the kind of government attitude that got us to this sorry state. “Money is a crucial issue. For instance, practices are unable to afford to pay willing and skilled GPs to work, junior doctors are increasingly seeking opportunities abroad due to significant pay declines over the past 15 years and our specialty and specialist doctors are left wondering whether the NHS values them at all. Of the respondents, 48% chose ‘increase taxes and spend more on the NHS’, it would be unwise to overlook this clear public appetite to adequately fund a better NHS. It is worth observing that there are many ways of increasing tax revenues without increasing the burden on individuals, but the principle of the more you earn, the more you should willingly contribute makes moral and ethical sense to us. The government must take heed to these findings and do all it can to rebuild an NHS where staff are properly valued, patients receive satisfactory care and the cost of reversing the falling trend in the health of this nation is seen as an investment not an ob…
Government Reaping Result Of ‘Not Listening To NHS Staff’ As Public Survey Shows NHS Needs A New Direction, Says BMA
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NHS leaders facing “drastic measures” to make ends meet as NHS responds to tightest financial settlement in years. Responding to the NHS Confederation’s survey of NHS leaders across trusts, integrated care boards (ICBs) and primary care in England, there was a clear call on the next government to protect local NHS organisations from having to further cut staffing levels. Matthew Taylor, chief executive of the NHS Confederation said: “The NHS is operating under immense financial strain, with some local services already cutting or freezing clinical and managerial posts, as well as cutting some patient services. They are facing up to some drastic measures to balance their books this year. “While NHS leaders know they must continue to run their services as efficiently as possible, this is the tightest financial position the NHS has faced in years”. Read the full survey 👇👇👇 https://lnkd.in/eHDnp6TJ
NHS leaders facing “drastic measures” to make ends meet as NHS responds to tightest financial settlement in years
nhsconfed.org
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Local NHS bodies on track to spend £4.9bn more than planned, exclusive data shows: Summary: 1. NHS integrated care systems (ICSs) in England are on track to overspend by £4.9 billion this financial year, based on data from 41 out of 42 ICSs. 2. Financial pressures are widespread, with all reporting ICSs being in deficit, and concerns are raised about the sustainability of day-to-day operations and planned investments. 3. Additional funding has been announced by NHS England, reducing the deficit to £420 million as of October, but challenges persist, including costs related to an upcoming strike by junior doctors. 4. Forecasts suggest a reduction in the deficit to £745 million in the next six months, but skepticism exists about the optimism of these projections, particularly given the impact of industrial action. 5. Industrial action, including strikes, has contributed to increased spending on agency and locum staff, with significant financial challenges faced by ICSs. Read the full Sky News article here: https://lnkd.in/eJQqJ6h9. #nhs #healthcare #nhstrust
Local NHS bodies on track to spend £4.9bn more than planned, exclusive data shows
news.sky.com
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*Winter Pressure* UK Government invests £200 million of new funding to boost NHS resilience and ensure patients receive the care they need this winter. UK Healthcare Recruitment Agencies, what are we waiting for ? Let’s smash the Q4 commencing next month! NHS Alongside this, £40 million is being invested to bolster social care capacity & improve discharge from hospital Funding will ensure patients are seen as quickly as possible, while also driving forward plans to cut waiting lists The new funding announced comes after Rishi Sunak & Health and Social Care Secretary met clinical leaders & NHS chiefs yesterday to drive forward planning to ease pressures in urgent & emergency care while protecting waiting list targets this winter. Winter is the busiest time for the NHS, with increased pressures from flu, Covid & seasonal illness – combined this year with ongoing pressure from industrial action. That’s why the government has started planning earlier than ever before to ensure patients get the care they need. The Urgent & Emergency Care Recovery Plan announced earlier this year was backed by £1 billion to boost capacity in the health system by providing 5,000 additional beds, 800 new ambulances and 10,000 virtual wards. As a result, significant progress has been made – compared to July 2022, Category 2 ambulance response times are now 27 minutes faster, there are 2,500 more general and acute beds and 9,700 virtual ward beds available, and there are 1,500 fewer people stuck in hospital when they are medically fit to be discharged. That comes on top of the Primary Care Recovery Plan which is freeing up 15 million GP appointments to help end the 8am rush. The government remains committed to cutting waiting lists – there has been good progress made on the Elective Recovery Plan with 2 year and 18 month waits eliminated so far. PM: Patients can be reassured that I will always back the NHS, so that those who most need help & support will get the care they need. Winter is the most challenging time for the health service, which is why we’ve been planning for it all year - with huge government investment to fund new ambulances, beds & virtual wards. This extra £200 million will bolster the health service during its busiest period, while protecting elective care so we can keep cutting waiting lists. #internationalrecruitment #outsourcing #offshoring #locumjobs #temporarystaffing #permanentstaffing #healthcarestaffing #subcontracting #ukrpo #ukrecruitment #internationalrpo #onshore #subcontractor #rpo #rposervices #india #uk #ukbusiness #internationalrecruitment #ukrecruitment #ukoutsourcing #nhs
£200 million to boost NHS resilience and care this winter
gov.uk
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It won’t be quick, but we are ready to work with the new government to ‘fix’ broken healthcare system. This is the response from The Royal College of Emergency Medicine (RCEM) as the new Labour government announces an ‘independent investigation’ into NHS performance. 🌐 Read the full story with all the links including to graphs and data here: tinyurl.com/RCEMNews117 In his first speech as Health and Social Care Secretary on Saturday (6 July 2024), Wes Streeting described the NHS as “broken” and has since set his aim of boosting economic growth from within the sector and improving access to primary care such as GPs. RCEM has today (Thursday 11 July 2024) pledged its support to the new government’s aim of ‘fixing’ the NHS but have warned that “efforts must be targeted to where they are most needed.” New data released by NHS England today (Thursday 11 July 2024), shows the scale of the task ahead, with almost one in 10 people waiting 12 hours or longer in A&Es in June. The data also shows in this period hospitals were 93.1% full, far above the level considered “safe” (85%). Difficulties discharging people due to a lack of appropriate social care options also meant a daily average of 21,976 people remained in hospital despite being well enough to go home. The effects of this backlog can also be seen in the ambulance service. Yesterday (July 10 2024), the Association of Ambulance Chief Executives (AACE) estimated that more than 32,000 people may have come to harm due to extended ambulance handover delays in May 2024 alone. Dr Ian Higginson, Vice President of RCEM said: “The Health Secretary was right, the NHS is broken, and the effects are seen nowhere more starkly than in Emergency Departments. RCEM has been clearly articulating the real picture for years, and it is refreshing to see a pragmatic and honest assessment of where we are and the scale of the challenge. “We are ready to work with the new government and we can help provide solutions. Those working on the front line, and those with expertise in the field, understand what is needed to restore NHS performance and the public’s trust in the health care system. “For this reason, we welcome today’s announcement for an independent review of NHS performance, it is a step forward for transparency and we will contribute in any way we can. “The Health Secretary has pledged to fix ‘the front door’ – improving access to GPs, and any improvements in community-based care is positive. “However, it is only part of the answer to improving patient care as a whole. The Emergency Care system continues to be under huge pressure as is clearly evidenced by the latest performance data. To make a significant improvement bed capacity needs to increase, and the beds that we do have need to be used more effectively. People need to be able to leave hospital as soon as they are well enough and... (continued) 🌐 Read the full story with all the links including to graphs and data here: tinyurl.com/RCEMNews117
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Waiting Lists and Patient Services are Casualties of Growing £1.7bn NHS Financial Black Hole New analysis from the Nuffield Trust think tank warns that despite an additional £450m of additional funding being made available to the NHS earlier this month, the current financial situation within the NHS is precarious with patients likely to feel the impact, with slower progress than hoped for on tackling waiting lists and initiatives to improve care quality and access stalled. The Nuffield Trust also warns that the situation could rapidly deteriorate further if more junior doctor and consultant strikes are called before the end of the financial year. The NHS has since been forced to scale back its spending on efforts to clear record waits by reducing its target for planned care from the waiting list from 105% to 103% of pre pandemic activity levels and directing stretched financial resources towards protecting urgent and emergency care over winter. The loosening of this target is intended to encourage NHS organisations to cut back on funding extra shifts and outsourcing work to the independent sector during the remainder of this fiscal year, in the hope of returning budgets to balance by April 2024. The overspend is a result of NHS outstripping its day-to-day budget, covering staff pay and clinical supplies, in the first half of this financial year by some estimated £3bn, and the staffing and logistical costs of strike action by NHS staff groups has overwhelmed this further. The analysis forms part of the first instalment of the Health and Care Finance Tracker, funded by the Nuffield Foundation, which will follow the financial health of the NHS and adult social care services as we head towards the next UK general election. It reveals: • If additional strikes by doctors to the scale seen in the first half of this fiscal year do take place, then the deficit could grow to almost £2.4bn, meaning the NHS would almost certainly need to seek additional funding in the Spring. • If strike action remains off the table for the remainder of the financial year, NHS England estimates suggest the NHS could expect to save around £700m due to a reduced overtime and temporary staff bill, as well as through being able to make better progress on planned efficiency savings. That would bring the deficit for the year down to £1.7bn but savings beyond that are very uncertain and virtually impossible to achieve without real impacts on patients. • There was already a £720m financial gap at the start of this financial year due to the gap between original budgeting and projected spending for local NHS systems. In the coming weeks, local NHS systems will set out revised plans for winter and to help return to financial balance and meet high demand. Difficult decisions will be inevitable as the NHS reprioritises already stretched resources and staffing. Nuffield Trust Senior Policy Analyst Sally Gainsbury said: “Given the NHS budget was already overstretched at the star…
Waiting Lists and Patient Services are Casualties of Growing £1.7bn NHS Financial Black Hole
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A link to my blog post
A link to my latest post about the broken NHS. https://lnkd.in/eRFkJ-JN
Fixing the broken NHS — Peter Brunskill
peterbrunskill.com
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