NHS financial crisis blocking plans to move care out of hospital, warn MPs

Plans to move NHS care out of hospitals and into community or primary care settings have been undermined by the growing financial crisis engulfing the health service, a report by MPs warns.

The deterioration in NHS finances over the past few years has become simply 'unsustainable', MPs on the House of Commons public accounts committee warned on Monday.

The financial situation across the health service has 'worsened considerably' since reports in 2015 and 2016, the committee warned, with numbers of hospital trusts in severe financial difficulty continuing to rise.

Warnings from MPs come just a week after NHS Improvement reported that NHS provider organisations were heading for a £750m to £850m deficit by the end of the current financial year.

NHS crisis

The BMA has warned this month that sustainability and transformation plans (STPs) were becoming unworkable because of the NHS financial crisis. The King's Fund think tank has also warned that the plans are not credible because they lack a mechanism for upfront investment in community services.

MPs on the public accounts committee echoed these points, highlighting that NHS England had 'a long way to go' before the public could feel confident that STPs were genuine vehicles for transformation of the health service rather than simply for cuts.

The report adds: 'To reduce the demand for expensive hospital care, the NHS needs to invest in alternative care models, such as primary and community services. But NHS England told us that us that the deficits in trusts mean there is £800m less money in 2016/17 to invest in out-of-hospital care and offset the increases in demand.'

The committee's report also warns that cuts to social care have driven up pressure on the NHS and that raids on capital funding to cover day-today spending pressures risk leaving hospitals 'ill equipped and inefficient'.

Patient access

Cuts aimed at bringing trusts' deficits under control are 'affecting patients' access to services and their overall experience of care' the report adds.

Public accounts committee chair Meg Hillier (Lab, Hackney South and Shoreditch) said: 'The NHS as we know it is under threat from growing and unsustainable financial pressures.

'Few trusts feel they have a credible plan for meeting the financial targets they have been set by government.

'At the same time, the government seems unable to get its own house in order – plundering NHS investment funds to plug holes elsewhere, and falling out in public over its longer-term strategy.

'Contradictory statements about funding from the prime minister and head of NHS England are an insult to taxpayers who deserve an honest, grown-up conversation about future finance and service provision.

'It is inconceivable the government would allow a catastrophic failure in the NHS and we expect it to take targeted action now to support NHS bodies facing severe financial problems.'

BMA chair Dr Mark Porter said: 'These MPs are the latest in a long line of people growing sceptical about the success of STPs.

'We already know that the vital funding needed to carry out these plans simply isn’t available. The simple fact is that the NHS is at breaking point because politicians have chosen to underfund our health and social care system and ignore the warnings of healthcare professionals. Tragically it is our patients who are unfairly suffering the consequences of these bad choices.'

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