Response to the Public Accounts Committee’s inquiry into NHS financial sustainability

We submitted written evidence to the Public Accounts Committee’s inquiry into NHS financial sustainability, which was called after a National Audit Office report of the same name was published in January. The report concludes that “the NHS long-term plan sets out a prudent approach to achieving the priorities and tests set by the government, but a number of risks remain” including the fact that current funding flows in the NHS do not support partnership working, patient waiting times are continuing to slip, and workforce shortages may hinder the ability of the NHS to use extra funding optimally. The report also questioned whether funding is reaching the right parts of the system –  highlighting CCG and provider deficits in the context of an NHS England underspend in 2017-18.

In our written evidence we highlighted that:

  • CCGs have been working to deliver maximum value from the NHS pound, and delivered an unprecedented amount of efficiency savings in 2017/18, however concerns around financial sustainability remain. In 2019/20, commissioners will continue to face the considerable challenge of delivering system financial balance whilst reconfiguring local structures and delivering new clinical priorities as set out in the NHS Long Term Plan.  CCGs have also been asked to deliver a 20% reduction in running costs by 2020/21 and will need to ensure that they are planning for and taking actions to achieve these reductions during 2019/20. This means that clinical commissioners will have to do more for less. As such CCGs will continue to have to make difficult decisions about how to best meet the needs of their local populations with the limited resources available to them.
  • As the National Audit Office report notes, there are currently barriers to achieving the best value for the NHS pound across local systems. CCGs have identified a number of barriers, including the current payment system, procurement requirements, and the nature of shared responsibility to improve health outcomes. These barriers should be addressed as a priority to ensure that the NHS pound is used most effectively across systems, and to free up time-consuming and potentially non-value adding procurement processes.
  • It’s also important to view the challenges facing CCGs within the wider context of a health and care system that is facing significant demand pressures. Any consideration of the financial sustainability of the NHS must recognise the important role of social care and public health provision and its impact on NHS sustainability. These services must be adequately funded if the overall system is to be sustainable and capable of delivering the best health outcomes for populations.

You can read our full response here.