Tough Financial Choice-Making by NHS Leaders for Preserving Patient Care Unveiled in King's Fund Research
The government's ambition to deliver major reforms for the National Health Service (NHS) is needed, but realism about what can be achieved in the current financial envelope is required, according to a new report published by The King's Fund health and care charity.
Despite a 22.6 billion GBP NHS funding increase announced in the 2024 Autumn Budget, the first iteration of financial plans for 2025/26 shows a 'very significant financial deficit' of 6.6 billion GBP for NHS systems. The report, published on 18th May 20XX, highlights that the NHS in England currently faces significant financial challenges centered around deep budget constraints, difficulties in balancing books while maintaining services, and the need to shift spending from crisis management to longer-term transformation.
Key financial challenges include persistent deficits and a culture of reliance on deficit funding rather than sustainable financial discipline, inefficient payment models, a pressing need to increase investment in community and neighborhood care while reducing hospital care expenditure, budget cuts and constraints at Integrated Care Board (ICB) levels, and the impact of financial pressures on the quality of care.
To address these challenges, the King’s Fund and related NHS strategic plans propose several solutions. These include financial planning reform, changing payment mechanisms, productivity improvement targets, rebalancing spending towards community care, resource allocation reform, governance and structural reforms, cost control at ICB level, and setting multi-year budgets for NHS Trusts.
Siva Anandaciva, Director of Policy at The King's Fund, states that it is right that the NHS is asked to be productive and deliver value-for-money, but also that it is right that the health service is set realistic goals. However, the report concludes that it will not be possible for the NHS to do everything that might be asked or expected of it in the current economic context.
The maintenance backlog to return NHS buildings and equipment to an acceptable standard has grown to 13.8 billion GBP. The study also highlights the challenges of maintaining high-quality services with budgets not keeping pace with demand. Public satisfaction with the NHS is at its lowest level since the survey began over 40 years ago, according to the latest British Social Attitudes survey.
The report calls for clarity about how the NHS should prioritize funding to deliver reforms versus maintaining current services. It underlines the difficulty of delivering much-needed reforms while also expecting rapid improvements to current services. The authors call for realism about the trade-offs needed to deliver essential NHS reforms in the context of tight public finances.
- To mitigate the financial deficit in digital health and enhance patient care, the King’s Fund suggests financial planning reform, changing payment mechanisms, and setting multi-year budgets for NHS Trusts in the health tech sector.
- The report published by The King’s Fund health and care charity emphasizes the need for health-and-wellness services to shift spending from crisis management to longer-term transformation and improve productivity.
- In response to budget cuts and constraints at Integrated Care Board (ICB) levels, the King’s Fund proposes cost control at ICB level and resource allocation reform to address financial challenges.
- As personal-finance and budgeting are equally relevant, it is crucial for the government to prioritize funding to deliver essential NHS reforms in the current economic context and ensure that investments in community care are balanced against hospital care expenditure in the interest of science and research.
