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“NHS hospitals will struggle to meet productivity targets” – King’s Fund 15th July 2011.

Filed Under (Health Policy, Kings Fund) by Paul on 20-07-2011

One of the consequences of the loss of public trust as a result of the Government’s NHS policy is that alternative sources of public information to the ‘official statistics’ will become more and more important.

I remember a period of time, about 2003-5, when NHS maximum waiting times were dramatically improving. However the public lost belief in the picture that was being painted by the monthly DH statistics. They felt that despite the fact that the official statistics were making the case that waiting times were improving quickly, they couldn’t explain why individually they had to wait so very long for their operations. (The reason being that at the time the government was reducing maximum waiting times for operations from 2 years to 6 months – and could feel very pleased with itself. While this IS a big improvement it is difficult to weigh the experience of what feels like a very long wait, against the headline which says waiting times are improving if you have to wait 6 months for an operation.)

When the public lose trust in Government figures they stop seeing them as a guide to helping their understanding of the NHS. In 2003-5 that meant that any independent report on the NHS became much much more important. If they said maximum waiting times were coming down, that looked like much better evidence that the official statistics.

I think the current Government is again in that position.

This makes the regular report from the King’s Fund a far bigger event for the public and the Government than it used to be. If I were in charge of communications for the Secretary of State for Health I would have the dates of their publication written in my diary together with some form of supportive quote.

Last Friday the King’s Fund reported on how well the NHS might be doing on the £20 billion QUIPP savings. They found that,

“Many NHS hospitals will struggle to deliver productivity improvements essential to maintaining quality and avoiding significant cuts to services.

The majority of finance directors from NHS providers questioned for this quarter’s report revealed that their trusts face productivity targets for 2011/12 of 6 per cent or more – well above the level required across the NHS as a whole to deliver the £20 billion in efficiency savings needed by 2015. Of these, more than half said they are ‘uncertain’ of meeting their targets.

The key findings obtained from our panel of NHS finance directors are:

  • Of the 29 finance directors who responded, 27 said their trust has a productivity target of 4 per cent or more, with 13 of these having targets of 6 per cent or more – all of them from provider organisations.
  • Around half the panel are uncertain of meeting their targets, while eight of the 13 panellists with targets of 6 per cent or more are uncertain of meeting them.
  • 26 of the 29 finance directors expect their trust to break even or be in surplus at the end of the year, with three expecting to be in deficit.
  • The majority are confident that measures taken to meet their targets will not harm clinical quality, although around a quarter are uncertain or concerned about this.
  • Nearly half the panel are pessimistic about the financial prospects for their local health economy, with only five of the panellists optimistic about this.”

To those of us working with the NHS at the moment this looks about right. Providers have cost improvement plans that are greater than other parts of the NHS and many will struggle to meet them. This will create an overall problem for the finances of the NHS.

John Appleby, Chief Economist at the King’s Fund, went on to comment,

“This quarter’s report suggests that the government is looking to NHS providers to deliver the lion’s share of productivity improvements, with many facing very tough cost improvement targets as a result. Based on the feedback we received, there must be significant doubt about whether many of these targets will be met. While waiting times remain low in historical terms, the rise against key target measures since this time last year shows how difficult it will be for the NHS to meet the Prime Minister’s pledge to keep waiting times low as the spending squeeze begins to bite.”

All this looks very measured.

This makes it all the odder for the DH to respond by saying that the think tank should not “talk down the NHS on the basis of one snapshot study”

As a line this is really difficult to take. Because the King’s Fund is critical of a Government aspiration the DH attacks it for ‘talking down the NHS’.  This is the same Government who only recently discovered how much it was in love with the NHS and who just a year ago wanted to change every hair on its head.

But to accuse the King’s Fund of talking down the NHS is just about the most desperate reaction from the Government I could imagine.

Just who do they think the public will trust on the NHS?

The King’s Fund?

Or Andrew Lansley??


One Response to ““NHS hospitals will struggle to meet productivity targets” – King’s Fund 15th July 2011.”

  1. Another dimension is that we now have a new EU Directive on Patients’ Rights in Cross-border Healthcare. If waiting times do start rising, people may start to vote with their feet, go to another EEA country for treatment and present the bills to their local PCT.

    Either way, the NHS pays….

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