Daily Insight: 'The Department of Health needs to get its act together'

Desperate measures

In what is certain not be to be last “desperate” measure to balance the budget in 2015-16, the Department of Health has sent external accountancy firms into 20 NHS organisations, just as they are preparing to close their accounts, HSJ revealed on Thursday.

The DH is perilously close to breaching its spending limit agreed by Parliament for 2015-16, and the review is designed to “support the health group accounts”.

One expert called the move an “act of desperation”, while an NHS finance director said it “goes against the grain of professional accounting and auditing”.

Focus areas will include “overly prudent” accounting around deferral of income and third party disputes, and “unnecessary provisioning” for restructuring.

That the department is doing everything it can to balance the budget isn’t all that surprising of course, but let’s remember that all this work will cost more money, and will do nothing to improve the underlying financial position.

Consequences of ‘desire to save money’

HSJ has been highlighting the national shortage of nurses affecting the NHS for a number of years, but on Thursday the Migration Advisory Committee underlined what many in the sector have known for some time, in a damning report on the government’s approach to workforce planning and particularly the supply of nursing.

The report is clear that over many years the “desire to save money” meant that training places were cut by 4,800 between 2009-10 and 2012-13, and that despite numerous warning signs that more nurses would be needed the NHS failed to invest in staff retention or pay, or consider the increased demand from an ageing population.

The committee said it would “reluctantly” recommend nursing remains on the shortage occupation list, which will make it easier for NHS trusts to recruit non-EU nurses, though it suggested this be capped at 3-5,000 nurses a year.

More worrying is that the MAC warned the same mistakes made in the past are happening again. It reports that Health Education England would have commissioned 3,000 extra nurse training places for 2016-17 but reduced this to just 331 – a tenth of what was needed – because of funding cuts to arm’s length bodies following the the spending review in November.

Professor Sir David Metcalf, chair of the committee, summed up the report by telling HSJ: “The Department of Health needs to get its act together.”