The government's modernisation agenda for the NHS is not achievable within the current timetable unless resources and staffing are increased, according to finance directors.
Finance directors attending last week's Healthcare Financial Management Association spring meeting said that although they would probably be able to balance the budgets in the current financial year and meet plan targets, the modernisation milestones they were supposed to meet looked unobtainable within the proposed timeframe.
But the pressures on some trusts, particularly the teaching and inner city hospitals, seem to have been recognised, with the government set to announce increases in funding for teaching hospitals by raising the money they are allocated from university funding.
NHS Executive acting finance director Christine Daws told HSJ that the coming year 'probably is going to be a very challenging year', and that the teaching hospitals had made it clear that the last year was 'one of the tightest years there has ever been.' But she said the problems were in 'a small number of areas'.
As part of the review of the overall position of the service and financial frameworks, a further£115m has also been released to regional offices to target specific problems. HSJ sources have said the intention has been to give extra, recurrent money to those trusts that had not received funds from the performance fund because of difficulties meeting targets.
University Hospitals Coventry and Warwickshire trust director of finance Paul Elkin said: 'What we will be able to do is meet all the key targets, but some of the addi-tional milestones are going to have to wait. These are milestones in the NHS plan - for example, introducing ward housekeepers. 'Our financial plan, along with most trusts, depends on achieving savings. Next year our plan depends on 2.25 per cent cash savings, about£3.5m.We are reasonably confident, but it is going to be more difficult than previous years.' Jones/Agnes Hunt Orthopaedic Hospital trust director of finance Wendy Farrington said cost savings of around 4 per cent were needed in the current financial year, around double the level of previous years. 'It will be extremely difficult to achieve. The risk is that we have to delay some of the targets in the modernisation plan. It is a timing issue.' Armstrong, who was finance director of St Mary's trust in London until the end of March, said a major factor in the trust's current deficit is the millions of pounds spent on agency staff, particularly nurses. She said it was hoped that an NHS agency agreement would be in place by September which would set a rate for staff lower than existing rates, currently as high as£35 per hour for nurses. But conference delegates made it clear it is not likely that large cost savings can be achieved by many trusts and that more money and staff are needed. They said the modernisation timetable should be relaxed by a couple of years if resources were not forthcoming. Junior health minister Lord Hunt told HSJ it was important 'we show the public that we are improving and meeting the targets' so 'the case for further investment' can be made. He added: 'If you can define the target sufficiently, the NHS is good at delivering it.'