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Long-term plan should ‘reset’ NHS performance and finances


By Valeria Fiore
Reporter
9 October 2018

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The long-term plan offers the NHS an opportunity for a ‘transformed and sustainable’ healthcare system, the trade organisation for trusts has said.

In a report published today, NHS Providers said that the health service should avoid repeating the errors of the past, which included the introduction of unachievable efficiency targets, as it drafts the long-term plan.

Making the most of the money – efficiency and the long term plan report collected 157 responses from 122 NHS trusts, more than half of the whole providers sector.

Reset present targets

Trust leaders believe that they can drive efficiencies at both local and system level, but not under the present circumstances, the report concluded.

It said: ‘[Trust leaders] are therefore looking to the long-term plan to set a stretching, yet deliverable, efficiency requirement of the sector. This requirement should be based on realistic assumptions and be accompanied by a framework setting out the potential areas of savings and the support trusts can expect from peers and national bodies.’

Financial deficits are becoming ‘the norm’ in the acute sector, the report said, and 102 trusts ended the 2017/18 financial year in the red.

A growing number of trusts are relying on ‘unsustainable one-off, or “non–recurrent” savings such as technical accounting adjustments, land sales, vacancy freezes and delaying essential maintenance works’ to comply with the efficiency requirements, the report argued.

Speaking at the NHS Providers Annual Conference and Exhibition 2018 in Manchester today, chief executive Chris Hopson said that providers now face a ‘frustrating paradox’ as they struggle to meet performance and financial targets under the current pressure.

He said: ‘The provider sector seems locked in a permanent cycle of debilitating public failure against its performance and financial targets.

‘Debilitating because however hard staff seem to work and however much they achieve, the trust sector can’t deliver the performance and financial task that has been set.’

‘Right national framework’ needed

NHS Providers’ report said that while trust leaders acknowledge their responsibility in making efficiencies, only 19% said they were confident their trust could achieve savings over the next five years.

Mr Hopson said that trusts need ‘the right national framework and the right support’ to drive efficiencies.

This support can be offered through the long-term plan, according to Mr Hopson, if it:

  • Looks at the growing demand
  • Tackles the workforce challenges
  • Sets achievable targets
  • Sheds clarity on how the system will be transformed
  • Sets the base for a relationship between national system leaders and local leaders based on respect.

Mr Hospson added: ‘[The Government] must ensure the NHS has the capital, public health and training budgets it needs when the next spending review completes its work and, above all, it absolutely must develop a robust long-term solution to social care.’

The Government recently announced an extra £240m for social care to cope with winter pressures ahead of the publication of the green paper on adult social care, which is expected to coincide with the annual spending review.

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