health and social care finances now and in the future - anita charlesworth
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#ntsummit
Health and social care finances now and in the future
Anita Charlesworth, Director of Research and Economics, The Health Foundation @AnitaCTHF
Chair: Dr Jennifer Dixon CBE, Chief Executive, The Health Foundation @JenniferTHF
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Looking ahead The state of finances in health and social care
Anita Charlesworth, Director of Research and
Economics, the Health Foundation
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Annual change in NHS spend per head in England
March 2016
Looking ahead: the state of finances in health and social care
Source: The Health Foundation, Nuffield Trust and Kings Fund ‘The spending review:
what does it mean for health and social care?’ December 2015
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Social care spending 2009/10 to 2019/20, real annual changes
March 2016
Looking ahead: the state of finances in health and social care
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Potential funding gap for adult social care in 2019/20, with likely impact of new minimum wage, based on projections from the government, OBR and PSSRU
March 2016
Looking ahead: the state of finances in health and social care
Source: The Health Foundation, Nuffield Trust and Kings Fund
‘The spending review: what does it mean for health and social care?’ December 2015
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Change in Public Health Allocations – 2015/16 to 2020/21 (2015/16 prices)
March 2016 Looking ahead: the state of finances in health and social care
-3.8%
-2.2%
£3.47bn
£3.07bn
-5.0%
-4.0%
-3.0%
-2.0%
-1.0%
0.0%
2.8
2.9
3.0
3.1
3.2
3.3
3.4
3.5
2015/16 2016/17 2017/18 2018/19 2019/20 2020/21
Allo
cati
on
(£
bn
)
Year-on-year real terms growth Real terms spend
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Net reported surplus/deficit for NHS providers between 2012/13 and quarter 3 of 2015/16, £m (2015/16 prices)
March 2016 Looking ahead: the state of finances in health and social care
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NHS QIPP savings 2011-12 to 2014/15
Year Outturn/forecast Saving (£ bn), cash
terms
Saving (£ bn) 2015/16
prices
2011-12 Outturn 5.8 5.9
2012-13 Outturn 5.0 5.1
2013-14 Outturn 4.3 4.4
2014-15 Outturn 1.8 1.8
TOTAL 16.9 17.1
Source: correspondence with NHS England on 04/02/2016
March 2016 Looking ahead: the state of finances in health and social care
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Factors associated with financial difficulty in 2014/15
March 2016 Looking ahead: the state of finances in health and social care
• A higher proportion of its staff spending is accounted for by
agency staff
• A higher proportion of income is paid through the national PbR
tariff
• Staff at the hospital are less happy for a friend or relative to be
treated there
• The trust received a rating of ‘inadequate’ following an inspection
by the CQC
• Not being a specialist provider
• Providing services from fewer sites
(Sample is 151 acute and specialist trusts, r^2 = 0.4597)
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Association between 66 hospitals’ financial position and their CQC risk inspection rating, 2014/15
March 2016
Looking ahead: the state of finances in health and social care
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Number of nurses employed in acute, general and elderly sectors, excluding bank and agency staff
March 2016
Looking ahead: the state of finances in health and social care
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Trends in nurse-to-patient ratio, admissions and length of stay, 2010 to 2015
March 2016
Looking ahead: the state of finances in health and social care
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Flow of nurses into and out of the NHS workforce 2014
March 2016
Looking ahead: the state of finances in health and social care
Source: National Audit Office analysis of data from Health Education England, the Health and Social care
Information Centre, The King’s Fund and NHS Professionals
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Qualified nursing and midwifery – leavers 2011/12 to 2014/15
March 2016
Looking ahead: the state of finances in health and social care
Source: Joint CSR Briefing the Health Fund, Kings Fund and Nuffield Trust
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Number of training places commissioners for clinical staff, 2004/05 to 2014/15
March 2016
Looking ahead: the state of finances in health and social care
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The public-private hourly pay differential for workers with similar characteristics
March 2016
Looking ahead: the state of finances in health and social care
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A comparison of estimates of NHS efficiency and productivity improvement
March 2016
Looking ahead: the state of finances in health and social care
Scope Annual
average
change
University of
York, 2016
England, NHS-wide Total Factor Productivity
(TFP) with quality adjusted output, 2004/05-
2011/13
1.4%
ONS, 2015 UK NHS-wide TFP with quality adjusted
output, 1995-2013
0.8%
Deloitte, 2014 English NHS acute hospital efficiency frontier
shift, 2008/09-2012/13
1.2%
The Health
Foundation,
2015
Acute care in English NHS hospitals,
2009/10-2013/14
0.4%
Monitor 2016 English NHS acute hospital trend efficiency
2008/09 -2013/14
1.4%
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Annual change in hospital productivity index, 2009/10 to 2014/15
March 2016
Looking ahead: the state of finances in health and social care
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Employment status of chief executive of NHS providers by type as of September 2015
March 2016
Looking ahead: the state of finances in health and social care