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Welfare Reform on the Web (August 2010): National Health Service - funding

50m fund for patients denied cancer drugs on NHS

R. Smith

Daily Telegraph, July 28th 2010, p. 12

Cancer sufferers who have been denied drugs on the NHS because they are too expensive could be provided with treatments not approved by NICE through a new 50m fund. Doctors will be able to prescribe drugs not normally available on the NHS subject to approval by a regional panel of clinicians.

Dealing with the downturn: using the evidence

N. Edwards

NHS Confederation, 2010

This report argues that NHS organisations will need to make large scale changes in order to realise cash savings. Delivering more care in the community will require the closure of hospital-based services. These changes will impact on frontline staff and lead to posts being axed. The report warns that changing skill mix by delegating more tasks to nurses may not save money due to lower productivity, higher recall rates and higher levels of tests and investigations. Similarly, incorporating community services into acute trusts may not reduce costs if the activities do not form part of the trusts' core business.

Employers keeps 1.8m surplus in new DH deal

S. Ford

Health Service Journal, July 15th 2010, p. 9

NHS Employers has signed a new three year contract with the Department of Health worth 11.7m in the first year and likely to fluctuate in value over the next two. The contract will involve managing NHS pay and pensions negotiations nationally on behalf of the government. However, NHS Employers could lose NHS Careers and NHS Jobs, which will both be put out to tender. The Department of Health has also agreed that NHS Employers can use a 1.8m surplus from their core contract to assist their cash flow and balance sheet position.

Equipped for change

D. Martin

Public Finance, Apr. 16th-22nd 2010, p. 24-25

A report from Siemens Financial Services shows that 1.85bn of NHS capital is locked into outright purchase of medical equipment. This money could be freed using alternative asset financing techniques such as leasing and rental, releasing scarce cash for other efficiency initiatives.

GPs may control 80bn in shake-up of NHS funding

D. Rose

The Times, July 12th 2010, p. 6

Andrew Lansley, the health secretary, has announced plans to shake-up the NHS which include giving GPs significant control of a large portion of the NHS budget. He has said that 1bn could be saved by reducing bureaucracy in the NHS. Medial leaders have suggested that any potential savings would be cancelled out by having to redeploy managers as advisers to GPs who are not trained to be financial managers responsible for large amounts of public money. (See also The Times, July 13th 2010, p. 16; The Guardian, July 13th 2010, p.1, 6 & 7; Financial Times July 12th 2010 p.5)

GPs to link with private firms over NHS cash

R. Smith

Daily Telegraph, July 22nd 2010, p. 14

Under government reform plans for the NHS, GPs are to form consortia to take responsibility for commissioning services. It has emerged that they will have the option of outsourcing commissioning to private companies, giving the latter control over NHS funds.

Hospital car park charges will stay

R. Smith

Daily Telegraph, July 21st 2010, p. 2

Unpopular hospital car parking charges are to remain in place in England as the coalition government has refused to carry out Labour's pledge to abolish them. The Department of Health argues that the decision should be made by individual hospitals.

Hospitals face shortfalls as emergency demand spirals

D. West

Health Service Journal, July 1st 2010, p. 4-5

An analysis of statistics shows that emergency hospital admissions rose by more than 8% between April 2008 and April 2010. The rise has come as new rules mean that trusts will be paid only 30% of the tariff rate for emergency activity above 2008 levels. Hospital trusts therefore face significant cash penalties in 2010/11.

Lansley challenges a decade of NHS spending

A. McLellan

Health Service Journal, June 24th 2010, p. 6-7

This article reports an interview with health secretary Andrew Lansley on his vision for the future of the NHS. The Coalition government is committed to raising NHS funding in real terms, but health spending will no longer increase as a proportion of national income. Rises will be modest. Cumulative efficiency savings of 20bn by March 2014 or 4% per annum are essential. Reforms will be driven by the transfer of responsibility for commissioning to GP consortia, which from 2012 will contrast with a new independent NHS board for services for a designated population. Hospitals will have more choice over which services they wish to provide, but will be expected to compete for business.

New arthritis drug about turn


Daily Telegraph, July 2nd 2010, p. 4

The National Institute for Health and Clinical Excellence has produced new draft guidance recommending the use of the drug tocilizumab as a last resort treatment for rheumatoid arthritis. Earlier guidance has rejected the drug, which demands funding of 10,000 per patient per year, on grounds of cost-effectiveness. The rethink came after the Institute obtained new data from the drug's manufacturer, Roche.

Soaring hospital admissions seen as threat to 'overheating' NHS

J. Laurance

The Independent, July 5th 2010, p. 20

Approximately 35 per cent of all admissions to NHS hospitals in England are classified as emergencies, a report by the Nuffield Trust reveals, costing approximately 11 billion a year. Admitting a patient to hospital as an emergency case is costly and frequently preventable, yet the number of emergency admissions to hospital has risen by 12% since 2005.

The performance and management of hospital PFI contracts

National Audit Office

London: TSO, 2010 (House of Commons papers, session 2010/11; HC 68)

According to this report most PFI hospital contracts are well-managed and the evidence indicates that they are currently achieving the value for money expected when the contracts were signed.. The cost and performance of services such as cleaning, laundry and portering in PFI hospitals are similar to those provided in non-PFI hospitals. While catering is on average slightly cheaper in PFI hospitals, hospitals with PFI buildings spend more on maintenance annually to keep them to a specified high standard. The report emphasizes the challenge involved in managing PFI contracts. Most Trusts are managing their contracts well day-to-day and understand the risks to value for money. However, risks remain and, while many Trusts have recently increased the resources they dedicate to managing PFI contracts, some Trusts are not devoting enough resources. It is likely that Trusts will be expected to make efficiency savings over the next few years, but their ability to make savings from their PFI contracts is very limited.

UK cancer funding: challenges for commissioning

S. Bojakowski

British Journal of Healthcare Management, vol.16, 2010, p. 332-335

The funding pressures on cancer services look set to continue to grow due increasing incidence, the availability of new technologies, and rising public expectations. To achieve world class cancer care, funding for cancer services needs to increase in the UK. That said, significant variations in spending on cancer persist in England. Commissioners need to understand these variations in cancer spending, to assess if it is inappropriately high or low, and to take action to address this.

What the doctor ordered

N. Plumridge

Public Finance, June 18th-24th 2010, p.14-15

This article presents an overview of current coalition government health service policy and of the financial challenges facing the NHS. These include the commitment to cut management costs by a third, the need to strengthen commissioning and improve productivity, and the challenge of reducing demand for healthcare by preventing illness.

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