NHS providers working hard, but still under pressure

NHS providers have risen to the challenge of record-breaking demand for services, but more work is needed to continue improving services for patients and increasing efficiencies in 2016/17.

Our analysis of providers' operational and financial performance shows that trusts saw an unprecedented 21 million emergency patients last year, while the sector as a whole made £2.9 billion in efficiency savings between April 2015 and March 2016.

NHS providers remain under continued pressure from further increases in demand for care, issues with discharging medically fit patients, and high costs, particularly of agency staff. As a result, many providers missed the national waiting time standard for A&E care and other operational performance measures in the last three months of 2015/16.

Financially, the sector ended 2015/16 in deficit (£2.45 billion) for the second successive year. Halfway through the year, the NHS reported a deficit of £1.6 billion, and predicted an end of year loss of £2.8 billion.

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Helping the sector to make savings

Analysis also shows that many providers are using the recently introduced financial control measures developed by the sector effectively.

For example, providers have used such measures to spend £300 million less than planned on agency staff since October 2015, and reduce by £86 million the sector's overall spending on management consultants compared to a year ago.

To further support NHS providers to make more savings we've launched the Financial Improvement Programme. Sixteen providers will be able to get help from external experts, saving around £50 million. The programme will also share examples of good practice across the NHS.

Our findings at a glance

A report to our board on the performance of the NHS provider sector: year ended 31 March 2016, shows:

  • overall the NHS provider sector reported a deficit of £2.45 billion, this is £461 million worse than planned
  • 157 (65%) out of 240 providers reported a deficit: the majority of these were acute trusts
  • providers estimated that delayed transfers of care have caused the sector £145 million in direct costs this financial year and 1.7 million bed days to be lost
  • providers paid £751 million in fines and readmission penalties to commissioners of which £253 million was re-invested in improving patients services
  • the provider sector spent £3.64 billion on agency and contract staff: £1.4 billion more than planned
  • providers made £2.9 billion of savings: £316 million less than planned
  • the NHS provider sector as a whole missed the A&E waiting time target of seeing 95% patients within 4 hours between January and March 2016
  • the size of the waiting list for routine operations reached 3.34 million as providers failed the referral to treatment healthcare standard in the last three months of 2015/16

Jim Mackey, Chief Executive of NHS Improvement, said:

"When we consider where we were six months ago, NHS providers have done a great job in reducing the planned deficit.

"The key now is for us all to work together to make the necessary improvements in 2016/17, to reduce any variations in the quality of care for patients, and to bring the NHS provider sector back into financial balance."

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