December 2014

HFMA NHS FINANCIAL TEMPERATURE CHECK

REPORTED DEFICIT - V - PLANNED DEFICIT Q2

FINANCIAL CONTEXT

FOUNDATION TRUST

NHS TRUST

£59mPLANNED DEFICIT

£254mREPORTED DEFICIT

£59mPLANNED DEFICIT

£254mREPORTED DEFICIT

£317mPLANNED DEFICIT

£376mREPORTED DEFICIT

£317mPLANNED DEFICIT

£376mREPORTED DEFICIT

FINANCIAL FORECASTING

of commissioner finance directors and 74% of trust finance directors are currently forecasting a worse 2014/15 year-end financial position than the 2013/14 year-end financial position.

of commissioner and trust finance directors are currently forecasting a worse 2014/15 year-end position than was planned at the start of the 2014/15 financial year.

39% 38%

Main drivers of worsening year-end financial forecasts according to more than 40% of trust finance directors

UNFORESEEN INCREASES IN

PAY COSTS

LOWER THAN EXPECTED SAVING FROM COST

IMPROVEMENT PLANS

DRIVERS OF FORECASTS

82% of trust finance directors say the pressure on pay costs is because of increasing agency staff costs. CCG CFOs’ main cost pressures are continuing healthcare costs (72%) and emergency care costs (70%).

FACTORS LEADING TO COST PRESSURES

of CCG CFOs intend to invest in community services.

of trust finance directors intend to make agency staff cost savings.

THE MAIN MECHANISMS FINANCE DIRECTORS INTEND TO USE TO DEAL WITH THE COST PRESSURES

87% 75%

MAIN CONCERNS ACROSS HEALTH ECONOMIES

of commissioners and 82%

of trust finance directors’ main concern about the financial health of their local health economies is the lack of system leadership

78%

of trust responses were for ‘none of the above’.

of area team finance directors’ total responses identified the area team as main system leader in their health economy.

of CCG CFOs’ total responses identified the CCG as main system leader in their health economy.

of trust finance directors’ total responses identified the trust as main system leader in their health economy.

SYSTEM LEADERSHIP IS NOT CLEAR

27% 32% 30% 10%

Despite being pessimistic about the financial position of the NHS for the current and future years, 94% of finance directors do not expect the quality of services to deteriorate in 2014/15 (92% in June 2014).

QUALITY OF SERVICES

WE’RE DOING AS WELL AS CAN BE EXPECTED UNDER THE FINANCIAL

CIRCUMSTANCES

QUALITY OF SERVICES

Aspects of service quality identified as most vulnerable by 2 out of 3 trust finance directors.

ACCESS TO SERVICES

WAITING TIMES

62% of trust finance directors and 86% of CCG CFOs think the better care fund will help to improve their organisations’ services for patients and service users after three years.

THE BETTER CARE FUND

HOME SWEET HOME

Only 2% of trust finance directors and 34% of CCG CFOs are confident that the benefits set out in the better care fund plans will be achieved.

THE BETTER CARE FUND

Only 14% of trust finance directors and 13% of CCG CFOs are totally confident about the assumptions underpinning years 1 and 2 of their five year plans.

FIVE YEAR PLANS

THE HFMA’S VIEWS

More funding is required

to enable the transformation

of the NHS

Faster progress on large

transformation schemes is

essential and requires system

leadership

National workforce planning

and training requires

improvement

Payment systems need to change