This project aims to explore whether the unprecedented slowdown in NHS funding growth since 2010 has affected patients’ access to high-quality care, and whether financial pressures are felt differently in different parts of the health system.
Project content
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Understanding NHS financial pressures
Severe financial pressures on the NHS show no signs of easing, but how are they affecting patient care?
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Six ways in which NHS financial pressures can affect patient care
NHS finances are almost at breaking point. What does this mean for people who access health services?
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How are NHS financial pressures affecting patient care?
Ruth Robertson looks at the ways in which NHS financial pressures can affect patient care, and the difficulties in assessing the real impact.
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Don't talk about the money?
Examples of where care is compromised by resource constraints are often most evident in stories from the local community, says Chief Executive of Healthwatch Essex Tom Nutt.
Why we're doing this project
The health service is midway through a decade of austerity that has been characterised by real-term reductions in budgets and increasing patient demand. By improving productivity and (in some cases) by overspending, the NHS has shielded patients from some of the effects of this financial challenge.
However, national bodies, commissioners, providers and individual clinicians are increasingly faced with tough decisions about patient care as they try to prioritise funding and balance their budgets. Different approaches to taking these decisions – sometimes referred to as 'rationing decisions' – have been looked at in previous work by The King’s Fund.
This project aims to explore whether and how the slowdown in NHS funding since 2010 has affected patients’ access to high-quality care. While The King’s Fund has reported extensively on the size of the financial issues facing the health service, this will be our first piece of in-depth research examining what this means for patients.
What we did
We examined the impact of financial pressures by looking in detail at four services, each commissioned through a different route. These are:
genito-urinary medicine clinics (local authority-commissioned public health service)
district nursing (CCG-commissioned service via block contracts)
elective hip replacement (CCG-commissioned service via tariff)
neonatal services (NHS England-commissioned specialised service).
In each area we:
explored the impact of financial pressures on access to services, patient experience and patient outcomes (recognising that in some areas financial pressures may have driven improvements in care)
identified barriers and enablers to maintaining access and quality while reducing cost per patient
explored whether financial pressures are felt differently in different parts of the health system
drew together our findings to highlight the common themes and put forward any general lessons for the NHS.
The research will include review of relevant literature, data analysis (where it is available) and interviews with patients, NHS staff and other key stakeholders.
If you work in one of these service areas or have used the service as a patient, we would like to hear your views on whether financial pressures have had an impact on the quality of patient care. Please contact Ruth Robertson, Fellow in Health Policy: [email protected]. All discussions are confidential and we will not identify research participants in our publication.