Lack of investment in new services puts NHS plan at risk

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The absence of ring-fenced funding for investing in new services could jeopardise plans to improve patient care outlined in the NHS five year forward view (Forward View), according to a new report from The King's Fund.

£2.1 billion has been allocated this year to a Sustainability and Transformation Fund (STF), which ministers said would enable the NHS to transform services and meet the ambitions set out in the Forward View. However, £1.8 billion of this funding is being used to reduce deficits among NHS providers, leaving just £300 million to invest in new services this year.

New guidance published by NHS England states that £1.8 billion has also been set aside to cover deficits in 2017/18 and 2018/19, leaving little to invest in transforming services. The King's Fund's report warns that this could put the plans outlined in the Forward View at risk.

The report argues that most progress in implementing the Forward View has been made in the new care models programme, in work on sustainability and transformation plans, and in plans to devolve more responsibility to public sector leaders in Greater Manchester. But with two out of the five years covered by the Forward View already elapsed, much remains to be done to align national policies with the improvements in care it is seeking to bring about.

More rapid progress is needed in the development of payment systems to support new care models, such as capitated budgets, in the regulation of care systems as well as organisations, and in the use of contracts to support primary and acute systems and multispecialty community providers. The law on procurement and tendering also needs to be clarified to avoid unnecessary delays and cost in implementing new care models.

The report argues that national leaders must allow time for the changes outlined in the Forward View to become established, with a continuing emphasis on these changes being led from within the NHS rather than being imposed top down.

Chris Ham, Chief Executive of The King's Fund, said:

'The future of the NHS depends on being able to implement the changes outlined in the Forward View.

‘New care models hold out the prospect of moderating rising levels of demand, including through better integration of health and social care and more investment in community services to provide alternatives to care in hospitals or care homes. These models are still under development, but the most advanced hold out real promise.

‘The challenge is that developing new care models requires investment, which is currently in short supply, as well as time. National leaders should hold their nerve, continue to support innovations now well under way, and work to remove legislative and policy barriers to progress.

‘By ring-fencing £1.8 billion for the next two years to reduce deficits, national NHS bodies are effectively leaving the NHS without the investment needed to deliver the transformation of services set out in the Forward View.’

Notes to editors

Notes to editors:

The NHS five year forward view progress report will be published on The King’s Fund website at 00.01 on Thursday 27 October.

In December 2015 the Health Secretary announced the new Sustainability and Transformation Fund.

NHS England’s Operational Planning and Contracting Guidance 2017-2019 sets out how the NHS will support sustainability and transformation plans and the ‘financial reset.'

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