Staff shortages could ‘presents a real risk’ to the impact of the £20.5bn NHS funding boost, the National Audit Office has said.
The NAO report said problems with recruitment could cause the extra money to be spent on ‘expensive agency staff’, or even go unspent as healthcare providers do not have the staff to deliver additional activity.
The funding increase – announced in June last year – also does not cover certain crucial areas, such as funding for doctors’ and nurses’ training, which could impede progress, the analysis said.
The findings come after the Government released the NHS long-term plan, which pledged £4.5bn of the £20.5bn to primary and community care, in return for practices being mandated to join primary care networks of 30-50,000 patients from April.
The NHS financial sustainability report, published by the NAO today, said: ‘The 3.4% average uplift in funding applies to the budget for NHS England and not to the department’s entire budget.’
Areas not included are ‘most capital investment for buildings and equipment, prevention initiatives run by Public Health England and local authorities, and funding for doctors’ and nurses’ training’. These will be adressed in the spending review later this year.
The report said: ‘Spending in these areas could affect the NHS’s ability to deliver the priorities of the long-term plan, especially if funding for these areas reduces.’
‘(The spending review) will tell us whether there is enough to deal with the embedded problems from the last few years and move the health system forward. Let’s hope there are not too many strings attached,’ it added.
The analysis continued: ‘Difficulties in recruiting NHS staff presents a real risk that some of the extra £20.5bn funding will either not be used optimally (more expensive agency staff will need to be used to deliver additional services) or will go unspent as even if commissioners have the resources to commission additional activity, health care providers may not have the staff to deliver it.’
The document also found the number of CCGs in deficit grew from 57 in 2016/17 to 75 in 2017/18, and commented on the increasing waiting lists and waiting times.
In April last year, NHS England board papers indicated 125 CCGs would report a deficit at the end of the year, up from 95 at the end of February.
A spokesperson for the NAO said: ‘The existence of substantial deficits in some parts of the system, offset by surpluses elsewhere coupled with growing waiting lists and year-on-year increases in waiting times, does not paint a picture that is sustainable.
‘The recent NHS long-term plan sets out a prudent approach to achieving the priorities and tests set by the government in return for its long-term funding settlement but a number of risks remain to the delivery of the plan.’
BMA council chair Dr Chaand Nagpaul said the report underlined the ‘increasingly precarious’ state the NHS was in.
He said: ‘It is deeply worrying that this assessment has found the NHS is not in a financially sustainable position, with parts of the system mired in deficits and overwhelmed by rising waiting lists that together are combining to damage patient care.’
‘We do need the Government to urgently ensure the NHS long-term plan is built into a strategy that not only provides stability, but also gives the NHS the resources to meet the growing needs of its patients and to fund a proper workforce,’ he added.
