An audit report said that there was only 'limited evidence' that all the cost savings claimed by the National Health Service, which equated to about 4 per cent of the budget each year, had actually been made.
Source: Progress in Making NHS Efficiency Savings, HC 686 (Session 2012–13), National Audit Office, TSO
Links: Report | NAO press release | Kings Fund press release | NHS Confederation press release | BBC report | Guardian report | Public Finance report
Date: 2012-Dec
A report said that the National Health Service could experience a £44-£54 billion funding gap in 2021-22 unless it delivered unprecedented productivity gains over the next decade, or public finances improved enough to allow health funding to increase faster than inflation.
Source: Adam Roberts, Louise Marshall, and Anita Charlesworth, A Decade of Austerity? The funding pressures facing the NHS from 2010/11 to 2021/22, Nuffield Trust
Links: Report | Nuffield Trust press release | Unite press release | Guardian report | Public Finance report | Telegraph report
Date: 2012-Dec
The new National Health Service Commissioning Board published guidelines on the incentives and levers that would be used to improve services in England from April 2013. Local poverty rates would no longer be taken into account in the allocation of funding.
Source: Everyone Counts: Planning for patients 2013/14, NHS Commissioning Board
Links: Guidelines | CB press release | Hansard | BMA press release | Kings Fund press release | Labour Party press release | NHS Confederation press release | RCGP press release | RCN press release | RCOG press release | Guardian report | Public Finance report
Date: 2012-Dec
An article examined the views of older adults who were receiving health and social care at the end of their lives on how services should be funded, and described their health-related expenditure. There was a gap between the health and social care system that older adults expected and what might be provided by a reformed welfare state at a time of financial stringencies. Participants expressed a belief in an earned entitlement to services funded from taxation, based on a broad sense of being a good citizen. Irrespective of social background, older people felt that those who could afford to pay for social care should do so. The sale of assets and the use of children's inheritance to fund care were widely perceived as unjust. The costs of living with illness were a burden, and families were filling many of the gaps left by welfare provision. People who had worked in low-wage occupations were most concerned to justify their acceptance of services, and distance themselves from what they described as welfare 'spongers' or 'layabouts.'
Source: Barbara Hanratty, Elizabeth Lowson, Louise Holmes, Gunn Grande, Julia Addington-Hall, Sheila Payne, and Jane Seymour, 'Funding health and social services for older people – a qualitative study of care recipients in the last year of life', Journal of the Royal Society of Medicine, Volume 105 Issue 5
Links: Article | RSM press release
Date: 2012-Dec
A report said that health spending fell across the European Union in 2010, both per person and as a percentage of national income – reversing increases seen in the years before the global economic crisis. After annual average growth of 4.6 per cent between 2000 and 2009, health spending per capita fell by 0.6 per cent in 2010. This was the first time health spending had fallen in Europe since 1975.
Source: Health at a Glance: Europe 2012, Organisation for Economic Co-operation and Development/European Commission
Links: Report | OECD press release | European Commission press release
Date: 2012-Nov
A think-tank report said that National Health Service funding arrangements encouraged acute hospitals to admit patients to hospital to service high fixed costs for staff and property, rather than trying to treat patients at a community level or in the home. Unnecessary admissions to hospitals had grown over the previous 10 years, fuelled by pay incentives that failed to encourage family doctors and consultants to work together in the best interests of the patient.
Source: Henry Featherstone, Altogether Now: Competitive integration in the NHS, Policy Exchange
Links: Report | Policy Exchange press release
Date: 2012-Nov
A think-tank report said that the way in which the National Health Service paid hospitals for the work that they did – including payment by results – should change to incentivize new models of care. Although payment by results had had a positive impact, existing payment systems might be obstructing changes in services required to meet existing and future healthcare needs. The system was not flexible enough to adapt to NHS objectives, which were more geared towards community-based treatment and reduced hospital activity.
Source: John Appleby, Tony Harrison, Loraine Hawkins, and Anna Dixon, Payment by Results: How can payment systems help to deliver better care?, King s Fund
Links: Report | Kings Fund press release | Monitor press release | Public Finance report
Date: 2012-Nov
The Department of Health published its annual report for 2011-12. At the same time the coalition government published updated figures for the costs and savings arising from National Health Service reorganization: it said that the costs were likely to be £300 million higher than previously thought, but that the savings over the transition period (2010-11 to 2014-15) would be £1 billion higher.
Source: Annual Report and Accounts 2011-12, HC 66, Department of Health, TSO
Date: 2012-Oct
A report by a committee of MPs said that an overall surplus of £2.1 billion across all National Health Service bodies in 2011-12 masked the fact that a significant minority were in financial difficulty. Yet the Department of Health could not explain how it would deal with a trust that went bankrupt; nor could it provide reassurance that financial problems would not damage the quality of care or equality of access.
Source: Department of Health: Securing the Future Financial Sustainability of the NHS, Sixteenth Report (Session 2012–13), HC 389, House of Commons Public Accounts Select Committee, TSO
Links: Report | NHS Confederation press release | RCN press release | BBC report | Guardian report | Public Finance report
Date: 2012-Oct
A paper reviewed 25 health expenditure forecasting models that had been developed for policy analysis by developed (OECD) countries and other international organizations.
Source: Roberto Astolfi, Luca Lorenzoni, and Jillian Oderkirk, A Comparative Analysis of Health Forecasting Methods, Health Working Paper 59, Organisation for Economic Co-operation and Development
Links: Paper
See also: Roberto Astolfi, Luca Lorenzoni, and Jillian Oderkirk, 'Informing policy makers about future health spending: a comparative analysis of forecasting methods in OECD countries', Health Policy, Volume 107 Issue 1
Date: 2012-Oct
An audit report said that National Health Service finances were healthy overall, but that a growing number of organizations were in deficit. Primary care trusts, strategic health authorities, and NHS trusts reported a combined surplus of £1.6 billion in 2011-12. Most trusts reported an improved financial position. But the number of trusts in deficit increased from 13 in 2010-11 to 31 in 2011-12.
Source: NHS Financial Year 2011/12, Audit Commission
Links: Report | Labour Party press release | RCN press release | Unite press release | BBC report | Guardian report
Date: 2012-Sep
A briefing paper examined the demographic and financial realities of social care and how these were likely to place additional pressure on the health and care system in the years ahead. In the long term, it was not sustainable to expect the funding shortfall of £2 billion for social care to come from the National Health Service.
Source: Papering over the Cracks: The impact of social care funding on the NHS, NHS Confederation
Links: Paper | NHS Confederation press release | Public Finance report
Date: 2012-Sep
An article examined and compared 25 models of healthcare expenditure that had been developed for policy analysis in developed (OECD) countries.
Source: Roberto Astolfi, Luca Lorenzoni, and Jillian Oderkirk, 'Informing policy makers about future health spending: a comparative analysis of forecasting methods in OECD countries', Health Policy, Volume 107 Issue 1
Links: Abstract
Date: 2012-Aug
An article examined the determinants of healthcare spending in Europe – taking into account the role of income, demographic ageing, technological progress, female labour force participation, and public budgetary variables. Healthcare spending was a multi-faceted phenomenon where a wide range of factors all played an important role. The comparison of total (public and private) spending revealed an imbalance of European welfare toward the care of the elderly. European governments needed to rely increasingly on pluralistic systems to balance sustainability and access, and to equalize the distribution of resources across the functions of the public welfare system.
Source: Fabio Pammolli, Massimo Riccaboni, and Laura Magazzini, 'The sustainability of European health care systems: beyond income and aging', European Journal of Health Economics, Volume 13 Number 5
Links: Abstract
See also: Fabio Pammolli, Massimo Riccaboni, and Laura Magazzini, The Sustainability of European Health Care Systems: Beyond income and aging, Munich Personal RePEc Archive
Date: 2012-Aug
Total government expenditure on mental health services fell by 1 per cent in real terms in 2011-12, the first annual reduction since 2001.
Source: Tony Ingham, 2011/12 National Survey of Investment in Adult Mental Health Services, Department of Health | Tony Ingham, 2011/12 National Survey of Investment In Mental Health Services for Older People, Department of Health
Links: Report (1) | Report (2) | Summary | Labour Party press release | YoungMinds press release | Community Care report | Guardian report
Date: 2012-Aug
A report examined future spending scenarios for the National Health Service in England. The real-terms freeze in NHS spending planned for 2010–11 to 2014–15 would, if delivered, be the tightest four-year period of funding in the previous 50 years. Meeting the tight plans for spending pencilled in for 2015–16 and 2016–17 would require real spending on other public services to be cut by an average of 1.7 per cent in each of these two years.
Source: Rowena Crawford and Carl Emmerson, NHS and Social Care Funding: The Outlook to 2021/22, Nuffield Trust
Links: Report | Nuffield Trust press release | IFS press release | ADASS press release | NHS Confederation press release | BBC report | Guardian report
Date: 2012-Jul
An article compared the types of benefit considered relevant by the Department of Health with those used by the National Institute for Health and Clinical Excellence (NICE) when conducting economic evaluations of options for spending healthcare resources. The Department and NICE approached resource allocation in different ways, based on overlapping but not congruent principles. There was a case for establishing a uniform framework for option appraisal and priority setting so as to avoid allocative inefficiency.
Source: Koonal Shah, Cecile Praet, Nancy Devlin, Jonathan Sussex, John Appleby, and David Parkin, 'Is the aim of the English health care system to maximize QALYs?', Journal of Health Services Research and Policy, Volume 17 Number 3
Links: Abstract
Date: 2012-Jul
New official figures showed that overall spending by government departments had been £6.7 billion lower in Session 2011–12 than planned. Cash departmental spending fell by £11.0 billion, which equated to a 5.2 per cent fall in real terms. The largest underspend was by the National Health Service – £1.7 billion, or 1.6 per cent of its Session 2011–12 budget – most of which would be taken back by the Treasury for use on non-health spending and tax cuts.
Source: Public Spending Statistics July 2012, HM Treasury
Links: Report | Background paper | IFS observation | Labour Party press release | BBC report | Guardian report
Date: 2012-Jul
An audit report said that in Session 2011–12 there had been a financial surplus of £2.1 billion across the National Health Service as a whole. However, there was a large gap between the strongest and weakest NHS organizations. 10 trusts, 21 foundation trusts, and three primary care trusts reported a combined deficit of £356 million. Without direct financial support, a further 15 trusts and 7 primary care trusts might have reported deficits.
Source: Securing the Future Financial Sustainability of the NHS, HC 191 (Session 2012–13), National Audit Office, TSO
Links: Report | NAO press release | CBI press release
Date: 2012-Jul
An audit report in Wales said that in Session 2011–12 National Health Service bodies had again reported significant cost savings, and that the Welsh Government had sought to put health finances on a more sustainable footing. There were positive signs for long-term reform to address unprecedented future financial challenges: but short-term funding gaps remained a concern.
Source: Health Finances, Wales Audit Office
Links: Report | WAO press release | Plaid Cymru press release | Welsh Government press release | BBC report
Date: 2012-Jul
A report by a committee of MSPs said that there was a 'lack of clarity' as to how Scotland's £11 billion annual health budget was being spent by National Health Service boards.
Source: NHS Boards Budget Scrutiny, 9th Report 2012, SP Paper 171, Scottish Parliament Health and Sport Committee
Links: Report | Scottish Parliament press release
Date: 2012-Jun
A report presented estimates of healthcare expenditure in the United Kingdom for the period 1997 to 2010. Expenditure (in current prices) totalled £140.8 billion in 2010, 3.1 per cent higher than in 2009. This was considerably lower than the growth rate in 2009 of 8.8 per cent.
Source: Adam Jurd, Expenditure on Healthcare in the UK 1997-2010, Office for National Statistics
Links: Report
Date: 2012-May
An article applied Scotland's formula for allocating healthcare spending to primary care trusts (PCTs) in England, Health Boards in Wales, and Health and Social Care Trusts in Northern Ireland, in order to assess relative healthcare expenditure needs. According to the Scottish formula, England's per capita healthcare expenditure need was around 10 per cent lower than Scotland's, Wales's was around 2 per cent lower, and Northern Ireland's was around 7 per cent lower. Scotland's higher expenditure need was largely a function of higher rates of mortality and long-term illness. Scotland's allocation formula also involved a different view from that in England of what constituted an equitable distribution of resources between PCTs.
Source: Rob Ball, David King, and David Eiser, 'Assessing the relative health care spending needs of the UK s devolved territories: a Scottish perspective', Environment and Planning C: Government and Policy, Volume 30 Number 2
Links: Abstract
Date: 2012-Apr
The government responded to a report by a committee of MPs on the financial pressures facing the National Health Service. It said that the benefits of its proposed reforms to the NHS would 'significantly outweigh' the challenge of managing the changes.
Source: Government Response to the House of Commons Health Committee Report on Public Expenditure, Cm 8283, Department of Health, TSO
Notes: MPs report (January 2012)
Date: 2012-Feb
A paper examined long-term trends in the healthcare financing mix in developed (OECD) countries, developing and applying a trichotomous concept that distinguished taxes, contributions, and private sources.
Source: Ralf Gotze and Achim Schmid, Healthcare Financing in OECD Countries: Beyond the public-private split, TranState Working Paper 160, Collaborative Research Center 597 (University of Bremen)
Links: Paper
Date: 2012-Feb
A report by a committee of MPs said that both the National Health Service and local authorities were struggling to meet cost-saving targets in a sustainable, long-term manner that would maintain high quality, efficient care in the future. There was a 'marked disconnect' between the concerns expressed by those responsible for delivering services and the relative optimism of the coalition government over achieving cuts. The coalition's simultaneous plans for reorganizing the NHS 'continued to complicate' the push for cost-cutting measures.
Source: Public Expenditure, Thirteenth Report (Session 2010-12), HC 1499, House of Commons Health Select Committee, TSO
Links: Report | Additional written evidence | ADASS press release | Kings Fund press release | Labour Party press release | NHS Confederation press release | Patients Association press release | RCN press release | RCP press release | RCS press release | Unite press release | Community Care report | Guardian report | Public Finance report | Telegraph report
Date: 2012-Jan
