• NHS England and Number 10 told by public accounts committee to grow up and work together
  • Repeated ‘crisis driven’ capital raids could have dire consequences, say MPs
  • MPs warn current ’sticking-plaster approach is not sustainable’
  • Local NHS organisations could be being asked to deliver unrealistic plans, report says

The high profile “bickering” between Theresa May and Simon Stevens over NHS funding is an “insult to tax payers” and undermines public confidence in the service, the public accounts committee has warned.

The MPs delivered the blunt message to the NHS England chief executive, the prime minister and other relevant system leaders in its latest report on NHS finances, which warned the current ”sticking-plaster approach is not sustainable”.

Committee chair Meg Hillier demanded an “honest, grown-up conversation about future [of the NHS]” for taxpayers and warned that only by working together would the NHS and government be able to address the health service’s “significant challenge”.

The Financial sustainability of the NHS report also raised concerns that repeated “crisis driven raids on [capital] funds” to prop up revenue spending could “result in ill equipped and inefficient hospitals”. It also said measures taken to restore financial stability were “affecting patients’ access to services and overall experience”.

A further concern raised was that local NHS organisations were being asked to deliver plans which were not “really achievable” and that the Department of Health and NHS system leaders did not understand how realistic their own plans were.

Ms Hillier said: “Contradictory statements about funding from the prime minister and head of NHS England are an insult to taxpayers who deserve an honest, grown-up conversation about future finance and service provision.”

“Government’s rigid adherence to a set of stock lines about funding, in the face of mounting evidence its plan isn’t up to the job, is not it.”

She added: “This sticking-plaster approach is not sustainable, will not enable the NHS to get ahead of the problems it faces, and represents neither good value to taxpayers nor the best interests of patients.”

Recommendations

  • The Department, NHS England and NHS Improvement should publish an assessment of whether there is the “capacity in NHS bodies to deliver everything they are expected to within the agreed timeframes” by March 2017.
  • DH, NHS England and NHS Improvement should set out a recovery plan by March 2017 which targets those NHS bodies and health economies in severe financial difficulty.
  • DH and NHS England should report back to PAC by July 2017 on what they have done to understand the association between financial performance and the impact on patient care.
  • DH and NHS England should assess and publish findings by July 2017 on the impact that financial pressure in social care is having on the NHS, “so that it can better understand the nature of the problem and how it can be managed”.
  • DH, NHS England and NHS Improvement should review and improve national and local planning for capital expenditure to “call a halt to crisis driven transfers out of capital budgets to meet day to day revenue spending, which is not good value for the taxpayer or the future of the estate”.
  • In its analysis of the 44 sustainability and transformation plan footprints, due by the end of March 2017, NHS England and NHS Improvement should set out how they will support organisations to deliver real transformation in the areas where plans fall short. “They also need to convince the public of the benefits of the plans to them.”

The committee’s evidence session for this report held last month began with Mr Stevens hitting back at criticism of his approach and his “unenthusiastic” attitude towards making savings by Downing Street sources.

Mr Stevens expressed his irritation and stated for the first time in public that he believed the NHS had received “less than we asked for” to fund the Five Year Forward View.

This contradicted the insistence by the prime minister and other ministers such as health minister Jeremy Hunt that the government has fully funding the NHS England blueprint.

Topics