The financial sustainability of health and social care is a serious and ongoing concern of the Committee. The Department of Health and Social Care’s 2017–18 Annual Report and Accounts suggests an improvement in fortunes when taken as a whole. But this masks the underlying deficits at a local level and the continued use of short term measures to reduce individual deficits, such as use of the sustainability and transformation fund and money to help with winter pressures. This overall figure also fails to show the regional variations and balancing act between the different health bodies. In 2017–18, 101 of 234 of NHS Providers were in deficit but this was largely off-set by a surplus in NHS England’s finances. NHS England achieved this surplus despite 75 of the 207 Clinical Commissioning Groups (CCGs) reporting an overspend. Recent reports that around a fifth of hospital trusts and health boards across the UK have missed their A&E, cancer treatment, and non-emergency surgery waiting time targets, hammer home the concerns we hold about the reality of the financial pressures on trusts at local level.
As part of its long-term plan for the NHS, the Department intends to ensure that finances balance at the individual NHS Provider and Clinical Commissioning Group level, as well as the system overall, but this is still some way off. In addition, the continuing uncertainties surrounding the long term funding of social care, the funding of NHS staff pay awards and the UK’s arrangements after leaving the European Union, with issues around workforce and medical supplies, highlight the challenges the Department continues to face. The 10 year plan must set out how these challenges will be met.
Published: 19 December 2018