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Welfare Reform on the Web (September 2011): National Health Service - funding

‘Crude estimates’ risk spending errors

C. Dowler

Health Service Journal, Aug. 25th 2011, p. 4-5

The NHS chief executive wrote to primary care trusts in August 2011 giving them just six weeks to submit returns for their total 2010/11 spending broken down to GP practice population level. Commissioning experts warned that crude estimates would have to be used to gauge more than half of the spending. These estimates were to be used to help set indicative allocations for emergent clinical commissioning groups (CCGs) in 2012/13, ahead of the allocation of real budgets in 2013/14. Consequently, some CCGs could find they were allocated insufficient funds to run their health system, while others would be over-funded.

The hire value way to purchase

L. Hamilton and B. Dredge

Health Service Journal, Aug. 25th 2011, p. 22-24

In the current difficult economic climate, relying on buying equipment outright is unlikely to be a realistic or sustainable strategy for the NHS. If the NHS is to gain access to the equipment and technology essential to deliver both quality services and cost savings, trusts will have to consider leasing as a solution.

The National Programme for IT in the NHS: an update on the delivery of detailed care records systems

Public Accounts Committee

London: TSO, 2011 (House of Commons papers, session 2010/12; HC1070) The report concludes that the Department of Health cannot achieve the aim of creating a fully integrated system of patient records across the NHS. The Department has been unable to demonstrate what benefits have been delivered from the £2.7bn spent on the project so far. Because of the failure to deliver the system, interim and local schemes have been devised, at even greater cost. The report also personally criticises the NHS chief executive Sir David Nicholson, who is accused of lacking capacity to meet his responsibilities fully, leading to increasing costs and delays. It is concluded that the further £4.3bn which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits.

NHS Financial Year 2010/11: a summary of auditors' work

Audit Commission


This report looked at the 2010/11 accounts of primary care trusts, hospitals excluding foundation trusts and strategic health authorities. It found that nine NHS trusts failed to achieve financial balance and at least 16 applied for extra money, although overall performance continued to be good. Primary care trusts gave £90m to hospitals, while the Department of Health issued loans totalling £34m to four hospitals and gave £76m to two trusts which could not repay loans. Health bodies spent £289m on redundancies but the number of hospital staff rose by almost 8,000. Total savings reported amounted to £4.3bn but this could include some double counting. On the other hand, NHS organisations overall were running a £1.5bn surplus and had underspent by £272m on the £2.95bn they had been allocated for capital investment, twice as much as in 2009/10.

NHS ‘one of the world's most efficient health systems’

R. Ramesh

The Guardian, Aug. 5th 2011, p. 11

The NHS is one of the most cost-effective health systems in the developed world, according to a study (pdf) published in the Journal of the Royal Society of Medicine. The "surprising" findings show the NHS saving more lives for each pound spent as a proportion of national wealth than any other country apart from Ireland over 25 years. Among the 17 countries considered, the United States healthcare system was among the least efficient and effective. Researchers said that this contradicted assertions by the health secretary, Andrew Lansley, that the NHS needed competition and choice to become more efficient.

NHS trusts ban non-emergency caesareans to save money


Daily Telegraph, Aug. 22nd 2011, p. 12

NHS trusts are banning pregnant women from having caesarean sections unless their health is at risk in order to save money. A planned caesarean section costs £800.00 more than a natural birth. A drop of 1% in the number of women having the procedure would save the NHS an estimated £5.6m per year.

Poor will lose out to the rich in radical NHS reform

R. Ramesh

The Guardian, Aug. 1st 2011, p. 12

Deprived parts of England will lose out to wealthier regions under radical health spending reforms, according to a study by Public Health Manchester for the parliamentary health select committee. Changes to the NHS funding formulas will see a reduction in funding to tackle entrenched health inequalities for areas with unhealthy populations such as those with low life expectancy and where levels of disease are above average.

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