Public Finance, Mar. 2nd-8th 2007, p. 14-15
The NHS's third quarter financial report in 2007/08 showed no less than three radically divergent bottom-line positions. This analysis attempts to explain the contradictions of different sets of figures which variously predict:
Health Service Journal, vol. 117, Mar. 1st 2007, p. 5
A survey of just under 100 NHS trust chief executives has shown that:
(See also Health Service Journal, vol.117, 1st Mar. 2007, p. 6-7)
Department of Health, 2007
The report concludes that the most important explanation for the emergence of deficits from 2004/05 onwards is probably slow adjustment to the accounting change which disallowed virement from capital to revenue accounts. This accounting change brought to light deficits which the NHS had previously been deliberately hiding. Bad workforce planning and the introduction of performance targets also contributed to the problem.
Department of Health
This consultation paper outlines plans to further roll out payment by results (PbR) in the NHS over the next four years to cover services beyond elective and emergency care. Improved data collection and clinical engagement are crucial if payment by results is to be extended beyond the acute sector. The government also intends to set up PbR development sites to test out proposals to extend the scope of the system. These sites will test out "local currencies for services outside the national tariff" and "alternative currencies or funding models for services already covered by the tariff". However, the plans to roll out a new version of the national health care resource group tariff which puts prices on different services has been delayed for a year. Other proposals include the introduction of "bonus payments" for providers offering patients excellent service.
Health Service Journal, vol.117, Mar. 8th 2007, p. 5
Primary care leaders called for changes in the way finances are reported after it emerged that the vast majority of primary care trust debts in 2006/07 were the result of top-slicing of funds. A proportion of primary care funds were being held in reserve by strategic health authorities to ensure overall financial balance in the NHS.
Health Service Journal, vol. 117, Mar. 29th 2007, p. 5
The Department of Health is to scrap the "double deficit" accounting system for acute trusts and will pay back fines taken from them in 2006-07. The move will see the resource accounting and budgeting system (RAB) abolished from April 1st 2007, as well as several trusts receiving rebates that will significantly reduce their end-of-year deficits. Under the RAB system introduced in 2001, trusts that run up an in-year deficit are penalised by the same amount the following year.
(See also Health Service Journal, vol.117, Mar. 29th 2007, p. 12-13)