Quality of care under threat as NHS enters watershed year

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Nearly two-thirds of NHS trust finance directors and more than half of clinical commissioning groups (CCG) finance leads(1) say the quality of patient care in their area has deteriorated over the past year, according to the latest Quarterly Monitoring Report from The King’s Fund.

The findings on the quality of care are the most worrying since The King’s Fund began tracking this question in 2012. Only 2 per cent of trust finance directors and 12 per cent of CCG finance leads said that patient care had improved over the past 12 months.

Looking back over 2015/16 as a whole, the report underlines the increasing strain the NHS is under as it struggles to manage increasing pressure on services within constrained resources. Data analysis carried out for the report highlights deteriorating performance over the year in several key areas:

  • 8 per cent of patients, more than 1.85 million, spent longer than four hours in A&E across the year, the worst performance since 2003/4
  • the number of patients waiting for hospital treatment is estimated to have risen to 3.7 million, an increase of 17 per cent (almost 500,000 patients) over the year and the highest number since 2007
  • at the end of March 2016, more than 5,700 patients were delayed in hospitals, an increase of 15 per cent over the year and the highest number since 2008.

The latest survey also confirms that 7 out of 10 NHS providers ended 2015/16 in deficit (including 9 out of 10 acute trusts).(2)

Looking ahead to 2016/17, the survey found that, despite £1.8 billion in allocated funding(3) and a concerted drive led by national NHS bodies to reduce overspending, more than half of trust finance directors expect their trust to end the year in deficit once again. Analysis undertaken for the report estimates that these deficits could add up to a £1.4 billion across the provider sector as a whole.

Detailed findings from the survey show that:

  • 38 per cent of trusts and 61 per cent of CCGs are concerned about meeting cost improvement targets in 2016/17
  • 82 per cent of trusts are either concerned or uncertain about meeting new control totals set by NHS regulators to reduce spending
  • nearly 20 per cent of CCGs expect to overspend their budgets this year, indicating that financial pressures are being felt by commissioners as well as providers.

John Appleby, Chief Economist at The King’s Fund, said:

‘Our latest survey confirms what we already knew, that 2015/16 was a very difficult year for the NHS, reflected in huge deficits and worsening performance. 2016/17 is a watershed year for the NHS in which it has been tasked with eradicating deficits and improving performance. Despite significant additional funding and a huge effort to contain deficits, it is clear that this is going to be a Herculean challenge.’


For further information, or to request an interview, please contact the Press and Public Affairs team on 020 7307 2585 or mediaoffice@kingsfund.org.uk (if calling out of hours, please ring 07584 146035).

Notes to editors

  1. 65 per cent of trust finance directors and 54 per cent of CCG finance leads felt that patient care had worsened in their local area in the past year.
  2. 67 per cent of providers ended 2015/16 in deficit, including 86 per cent of acute trusts.
  3. On 16 December 2015, the government announced a £1.8 billion fund for 2016/17 which will be used to support NHS providers in reducing deficits and improving services.
  4. QMR details the results of an online survey of NHS trust finance directors carried out between 8 April and 3 May 2016. We contacted 241 NHS trust finance directors to take part and 87 responded (36 per cent response rate). The sample included 36 acute trusts; 35 community and mental health trusts; 6 specialist trusts; 3 ambulance trusts and 7 unknown. This sample broadly reflects the composition of NHS providers in England. In addition, we made contact with 149 clinical commissioning group (CCG) finance leads and 42 responded (28 per cent response rate). Between them these finance leads covered 47 CCGs (22 per cent of all CCGs).
  5. The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.