Summary
Over the last three years spending on specialised services has increased at a faster rate (6.3% a year) than the NHS as a whole (3.5% a year) and now accounts for about 14% of the total NHS budget. We are concerned that, despite the large increase in the budget for specialised services, NHS England has not kept its spending within the budget it set itself. The disproportionate growth in spending on specialised services poses a corresponding risk to financial sustainability of the wider NHS and, if NHS England is unable to keep its spending on these services in control, this will affect its ability to resource other health services and wider health transformation set out in its Five Year Forward View. To remain within its budget for specialised commissioning, NHS England will need to make tough decisions. These include taking action in three areas: (a) ensuring new drugs and medical equipment are affordable; (b) ensuring services are delivered cost-effectively; and (c) better management of the level of demand for the specialised services it commissions. When taking action to control its spending on specialised services, NHS England also needs to work closely with NHS acute providers to avoid adding undue pressures to their budgets. We recognise that it is challenging to commission such a wide range of complex services while funding is becoming increasingly tight. However, we are concerned that NHS England and the Department of Health painted an unduly healthy picture of the state of commissioning specialised services in England. It is disappointing that, after three years, NHS England still does not have consistent information from all providers on costs, access to services and outcomes, or how efficiently services are being delivered. Without this information it cannot manage the ongoing pressure on its budget, make effective strategic decisions or gain assurance that its objectives for these services are being met.
© Parliamentary copyright 2015
12 July 2016