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English NHS trusts' deficit 'halved over course of a year'

Published 25/08/2016

Health experts warned it would be a mistake to think financial pressures have eased
Health experts warned it would be a mistake to think financial pressures have eased

The size of the deficit for NHS trusts in England halved over the course of a year, with more trusts meeting their financial targets, figures show.

With the total deficit falling to £461 million for April to June, down from £930 million in the same period last year, health experts are nevertheless warning it would be a "mistake" to think financial pressures have eased.

The NHS Improvement report also highlights a reduction in the number of trusts reporting a year-to-date deficit, with a decline from 190 to 153 - a drop of almost a fifth (19%). But a majority of the 238 trusts in England are still running a deficit.

Despite the savings the waiting list for elective care, including scheduled operations, reached the highest recorded level of 3.45 million.

Figures also show that in the first three months of this financial year, there were 5.34 million attendances at England's accident and emergency departments.

This is a rise of more than 300,000 on the same period last year - with the number of patients who needed to be admitted also increasing by more than 6%.

Despite the change in the number of patients, A&E departments treated nearly 73,000 more patients within the four-hour national target - but still fell below the national target of 95% for treating, admitting and discharging patients in the time frame, with a rate of 89.31%.

And more than 112,117 patients waited longer than four hours on a trolley for a bed, an increase of 60.7% compared with last year.

Ambulance calls rose by 5.9% for time-critical jobs Red One, and by 15.5% for life-threatening jobs Red Two - resulting in all services failing to achieve key response time targets.

On top of waiting lists reaching the highest recorded level, trusts continued to experience difficulties in providing first treatments to 85% of urgent GP referrals for suspected cancer sufferers within 62 days - achieving this in just 82.34% of cases.

Jim Mackey, chief executive of NHS Improvement, said "there is still much work to be done".

"Today's figures demonstrate that providers are meeting some of the ambitious plans that trusts boards have signed up to and this is a promising start to the year," he said.

"The performance data is more disappointing. While the majority of NHS trusts are meeting the extra demand from patients and still delivering a high-quality service, a small group are letting the side down.

"We need to support them to up their game so they provide the services patients rely on."

In a bid to plug the gap, the NHS invested an extra £1.8 billion in trusts' sustainability, and introduced tough financial controls on deficit contributors such as agency spending.

Since the agency limits were introduced in October last year, the report states that trusts have reduced the ad hoc staffing bill by £500 million - with 6.1% of the total NHS pay bill spent on agency staff so far this financial year.

Richard Murray, director of policy at the King's Fund, said the deficit change is "welcome".

"But it would be a mistake to suggest that the financial pressures which have engulfed the NHS have eased," he added.

"Extra investment and the hard work of staff mean that NHS organisations are still just about coping for the time being, but the service is reaching a critical point," he said.

"The Government must be honest with the public about what the NHS can achieve with the resources it has been given.

"It is not credible to argue that it can continue to meet rising demand for services, maintain standards of care and balance its books within its current budget."

Sally Gainsbury, a senior policy analyst at the Nuffield Trust, warned there is a "real risk" the figures give a "rose-tinted view of a more troubling underlying picture".

NHS Providers chief executive Chris Hopson said any sense of optimism must be tempered by what trust finance directors are saying. Referencing the body's own study, he warned that nearly four out of 10 predict they "expect their trust's position to worsen".

He added: "This will only get worse as overall funding increases drop from next year.

"In reality, we have only just kept our heads above water because we have transferred the investment intended to fund long term transformation into reducing the deficit that the majority of NHS trusts face."

A Department of Health spokesman said: "The NHS is making progress towards balancing the books, but there is no room for complacency.

"That's why it needs to stick to its strong financial plan, supported by our £10 billion investment and series of measures to help hospitals become more efficient and reduce the use of expensive agency staff."

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