King’s Fund forecasts hard winter

The King’s Fund has warned that the NHS is in for a hard winter, as its latest quarterly monitoring report shows a further deterioration in trust finances.

The think-tank’s latest survey of NHS finance directors has found that 60% of trusts are concerned they will miss their cost improvement targets this year and that 40% predict they will end the year in deficit.

“Despite a reported £930m of additional government funding to improve hospital waiting times and ease pressure in A&E, this points to a challenging winter ahead,” the report concludes.

Last week, NHS England chief executive Simon Stevens issued a ‘Five Year Forward View’ for the NHS that claimed it could close the £30 billion predicted gap between funding and demand by 2020-21; as long as politicians, the NHS, and patients took action.

The 5YFV said the gap could be “closed completely” as long as more money was found for the NHS, it used this money to invest in better quality treatment and new service models, and patients backed these and took note of public health campaigns on smoking, drinking and obesity.

However, no major political party has agreed to commit the money to the NHS that the report calls for. And the deterioration in NHS finances picked up by the King’s Fund suggests trusts will struggle to get to the end of the financial year and then invest from a position of strength.

One of the areas in which investment will be needed is IT. The 5YFV says national systems will need to become the ‘glue’ of the new system, and that integrated electronic health records will be needed pass information around it.

The report also calls for further investment in apps and other consumer technology to “engage” patients in their health and care. The National Information Board is due to issue ‘roadmaps’ for these developments next month.

Meanwhile, the King’s Fund report warns that NHS performance against key targets is deteriorating along with its finances.

It notes that waiting time targets for A&E waits, inpatient treatment and cancer treatment were all missed in the quarter starting in July and ending in September; when the NHS is traditionally quiet.

Richard Murray, the director of policy at the King’s Fund, commented: “The number of trusts forecasting deficits indicates that financial problems are no longer confined to a small number of organisations and are now endemic across the health system.

“At this time of year, A&E waiting times should be well within target range, so the fact that trusts are continuing to miss the 5% target [for not treating or admitting patients within four hours] is a significant cause for concern.

The number of inpatients who waited more than 18 weeks from referral to treatment has now risen to 12.1%; the highest level since 2008.

The number of delayed transfers of care has also risen by 17.5% in comparison to the same period last year; suggesting that even worse pressures on councils, which run social care, are impacting on trusts.