Nuffield Trust response to NHSI figures

Finances look grim, but shortage of workers even bigger problem.

Press release

Published: 21/02/2018

Commenting on the financial figures for NHS trusts laid out in today’s NHS Improvement Quarter 3 report [1], Nuffield Trust Senior Policy Analyst Sally Gainsbury said:

“Despite very hard work in NHS trusts, today’s financial figures make grim reading. As we predicted at the start of this year, reported deficits are set to be in the region of a billion pounds this year. Even this figure disguises a real underlying deficit of close to £4bn which will roll on from year to year, after one-off sources of money are taken out [2].

“NHS Improvement have shown increasing transparency and openness in setting out more data on productivity. This should help us face up to the reality that the savings being demanded are just not realistic. Trusts have been asked to save 4% of their costs for the seventh year running, twice what the Government has been advised is possible. They are on course to make a remarkable £3.3bn in savings, but even this is not enough and relies on much more one-off savings than was planned.  

Commenting on new figures for staff vacancies in the report, Nuffield Trust Chief Executive Nigel Edwards said:

“Publishing figures on workforce vacancies is also a very positive step from the regulator. Sadly, they show no improvement in the dangerous shortage of nurses, and a worrying picture for doctors.

“Shortages of nurses damage patient care and make working life harder for those who remain, potentially driving them away too. We have warned that current policies are completely inadequate to the scale of the problem [3], and these figures confirm that we are stuck with more than one in ten posts left vacant. There is no sign of nursing applications increasing enough. A new language test and the prospect of a Brexit migration crackdown are turning away the European nurses who were stopping the problem spiralling out of control.

“These figures also show that 8% of posts for doctors are left vacant – a marked increase on the figure the NAO found in 2014 [4]. Particularly troubling is a 12% vacancy rate for doctors in mental health services. We have known about this problem for a long time, yet despite the stated priority given to mental health it does not seem to be getting any better.

“In some ways, the lack of crucial workers in the NHS is an even bigger problem than the lack of funding. We can sign a cheque and bring back more money onstream if the will is there, but there is no button to push which will suddenly bring us tens of thousands of qualified extra staff.”

Notes to editors

[1] NHS Improvement’s “Performance of the NHS provider sector” report provides figures on performance and finances for NHS trusts in England from October to December 2017. For the first time it includes information on staff vacancies.

[2] Our publication last year, The Bottom Line, projected NHS finances for the next few years and drew attention to the size of the underlying deficit, which is the size of the loss the NHS trust sector is running at after accountancy adjustments, one-off savings and temporary funds are stripped out.

[3] See our response to the Workforce Strategy.

[4] The National Audit Office reported that in 2014 shortfalls for junior doctors were at 4.3%, and consultants at 5.3%.

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