health and social care finances now and in the future - anita charlesworth

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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

Looking ahead The state of finances in health and social care

Anita Charlesworth, Director of Research and

Economics, the Health Foundation

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

Social care spending 2009/10 to 2019/20, real annual changes

March 2016


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


Source: The Health Foundation, Nuffield Trust and Kings Fund

‘The spending review: what does it mean for health and social care?’ December 2015

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

Net reported surplus/deficit for NHS providers between 2012/13 and quarter 3 of 2015/16, £m (2015/16 prices)


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


Factors associated with financial difficulty in 2014/15


• 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)

Association between 66 hospitals’ financial position and their CQC risk inspection rating, 2014/15

March 2016


Number of nurses employed in acute, general and elderly sectors, excluding bank and agency staff

March 2016


Trends in nurse-to-patient ratio, admissions and length of stay, 2010 to 2015

March 2016


Flow of nurses into and out of the NHS workforce 2014

March 2016


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

Qualified nursing and midwifery – leavers 2011/12 to 2014/15

March 2016


Source: Joint CSR Briefing the Health Fund, Kings Fund and Nuffield Trust

Number of training places commissioners for clinical staff, 2004/05 to 2014/15

March 2016


The public-private hourly pay differential for workers with similar characteristics

March 2016


A comparison of estimates of NHS efficiency and productivity improvement

March 2016


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%

Annual change in hospital productivity index, 2009/10 to 2014/15

March 2016


Employment status of chief executive of NHS providers by type as of September 2015

March 2016


health and social care finances now and in the future - anita charlesworth

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