Don’t use new money to grow old NHS, warns NHS England boss

4 July 2018
NHS England’s operations director has warned that the five year investment plan announced in June must avoid the mistakes made when the health service last experienced
a significant and sustained funding rise.
 
Matthew Swindells said that the big increases before the financial crisis in 2008 had been spent on “expanding the hospital base and employing more consultants” – resulting in
“a bigger, old NHS”.
 
He said that the average annual funding rise of 3.4% up to 2023 announced by prime minister Theresa May should be directed to primary care where professionals ‘acting at the top of their licence’ should manage population health by making best use of data.
 
Addressing a recent event on financial sustainability, Swindells pointed out that the five year funding rise hardly represents a bonanza – not least because it is below the health service’s historic
average rise in spending.
 
Urging his audience to continue to embrace innovation in the search for efficiencies, he noted that the increase did not apply to this financial year and it would only have a real impact if the health service changes.
 
“We need to get patients to the right place for getting the right care to stop waiting lists growing, to prevent A&E departments being jammed up and to ensure primary care is not in crisis. We need to be working now to ensure that the extra funding is an investment in the future and not just a patch for short term problems. We cannot relax. We need to be brave about change.”
 
Benchmarking and embracing the work of programmes such as NHS RightCare and Getting it Right First Time (GIRFT) could help local health systems achieve sustainable finances
while maintaining and improving services, he said.
 
Pointing to one clinical commissioning group (CCG) which had consulted on cutting IVF services last year to save £700,000, he said analysis of the area’s finances had shown it was spending £23 million more on outpatient appointments than comparable CCGs.
 
“Even if they removed just 5% of that figure they wouldn’t need to be talking about cutting IVF services,” he said.
 
“We need to be working now to ensure that the extra funding is an investment in the future and not just a patch for short term problems. We cannot relax. We need to be brave about change.”
 
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