In brief
- The NHS is facing the most significant financial challenge in its history. After seeing real spending on the health service in England more than double from £46 billion in 1999/2000 to £106 billion in 2010/11, the NHS is now set to enter a period of uncertainty in which growth in its budget will be severely constrained. At the same time, improving the quality of care patients receive and their overall experience is a key priority for the NHS. Delivering improved quality and meeting growing demand for health care at a time of unprecedented financial constraints will present the most significant leadership challenge for the NHS over the coming years.
- The King’s Fund Quality in a Cold Climate programme aims to help the NHS respond to this challenge. It will provide NHS leaders with analysis and advice on the scale of the financial challenge facing the health service and the implications for action. The programme will support managers and professionals to identify the levers, actions and incentives necessary and then work with them to help deliver the changes and evaluate their impact.
- We will conduct a range of activities, including:
- original research and analysis into the financial climate – at both a national and local level
- collecting evidence on, and identifying, interventions that could improve quality while reducing spend
- working with NHS test sites on specific topics that may best support the health service to deliver service re-design.
- We will work with professionals to support and evaluate implementation of interventions that have a proven record of delivering benefits in terms of quality and finance. We are also hosting a number of high-profile debates, seminars and conferences that will explore the implications for the NHS of entering a period of low or zero growth in its funding.
- Quality in a Cold Climate will run until approximately the end of 2010 and combines input from The King’s Fund’s policy, leadership and health care improvement directorates.
- Its first major output was a joint report by The King’s Fund and the Institute for Fiscal Studies: How cold will it be? Prospects for NHS funding: 2011-2017. Published in July 2009, the report outlined the scale of the financial challenge facing the NHS and examined three plausible funding futures for the NHS in England over the next two comprehensive spending review periods – 2011/12 to 2016/17. It concluded that even under the most optimistic funding scenario, the NHS will struggle to meet people’s health care needs without significant increases in productivity.
- The findings from a simulation exercise (commissioned by The King's Fund and led by Loop2) to explore the likely impact of the financial squeeze on system dynamics within health and social care have been published in Windmill 2009: NHS response to the financial storm. The simulation shows that the NHS will be able to continue to meet demand and improve quality only if primary care trusts are honest about the challenges ahead and can engage the public and health care staff in their proposals to improve quality while reducing costs.
