Cash worries 'could harm drive to improve NHS care'

Nurse The Nuffield Trust is concerned money worries could undermine efforts to improve care

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Financial pressures could get in the way of the drive to improve care following the Stafford Hospital scandal, experts say.

Figures released last week showed nearly one in three NHS trusts is forecasting a deficit this year.

Now a review by the Nuffield Trust - published a year on from the Stafford public inquiry - said money worries could hamper efforts.

The warning was echoed by inquiry chair Robert Francis QC.

He criticised what he saw as the "oppressive reactions" of the system to hospitals that ran into trouble with budgets and hitting targets.

He said hospital leaders needed to be "frank" about whether they could provide high-quality care with current levels of funding.

"It is unacceptable to pretend that all can be provided to an acceptable standard when that is not true," he added.

'Safety and quality'

Mr Francis was responding to a report by the Nuffield Trust based on in-depth interviews with 50 staff at five hospitals and online feedback from chairs and chief executives of 53.

Many reported they were taking action to improve care, but their overwhelming concern was that the state of finances was going to harm their ability to succeed.

One hospital chairman said: "The one good thing Francis has done, the really good thing, is that it has ensured that safety and quality have become more prominent - that's really important.

Start Quote

Things are moving in the right direction. I believe people working in the NHS have a real appetite for change”

End Quote Julie Bailey Cure the NHS

"But I am left with a real concern about the doability of it all and the need for us to find a way forward."

But despite these concerns, Mr Francis said he was pleased with the reaction to his report, published exactly a year ago, as many of his recommendations had been accepted.

"The strong message sent out to the health service by government was that important and fundamental change was required," Mr Francis said.

But he added that this represented "only a start" and that the emphasis on quality of care needed to continue.

Julie Bailey, founder of Cure the NHS, the campaign group that led the calls for the public inquiry, said she was disappointed the government had not agreed to full regulation of healthcare assistants, as the Francis Inquiry had recommended.

But she added that overall she was pleased with the progress being made.

"Things are moving in the right direction. I believe people working in the NHS have a real appetite for change."

The publication of the report came after Health Secretary Jeremy Hunt praised the "Francis effect" in a speech to NHS staff in London on Wednesday.

"Twelve months on, we cannot expect to have solved everything or have completely transformed the culture of the country's largest and finest institution.

"But we have seen a real shift in priorities - new inspections, more nurses and a stronger voice for patients with compassionate care starting to replace tick-box targets as the major focus on boards and wards."


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  • rate this

    Comment number 275.

    Following on from 263, I forgot to mention that 95% of GPs are PRIVATE contractors who SELL their services to the NHS and rake in excessive profits which they distribute to themselves as "salary."

  • rate this

    Comment number 274.

    255 Matty.

    I agree there are a lot of problems with how the NHS is currently mismanaged, which is why the shadow of privatisation needs to be eradicated. Yes there are inflated salaries but there are also very poorly underpaid staff too, this has happened through treating it like a business and outsourcing.
    I don't have all the answers, I can't fix it but as a population we can.

  • Comment number 273.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 272.

    I want that consumer power (freedom of choice) with my entire healthcare
    And you are allowed to have it, but you also have to contribute to the healthcare of those who wouldn't be able to afford adequate care without support.
    I have 0 choice to not reward the same mob running Stafford Hospital; the NHS. Also, where is the choice of those poor to choose other than the NHS?

  • rate this

    Comment number 271.

    Risky question, but: why are we striving so hard to prolong old age? Devote resources to sick kids and working age people, yes, but if Mum gets scared at night she rings 999 and stays in 3 weeks for tests etc. She's 87 and doesn't want to live forever, just doesn't want to die alone in pain. We need something new for the oldies who don't need to be hospitalised.

  • rate this

    Comment number 270.

    When the Tories scrapped the national NHS IT programme for purely political reasons, they thus condemned every single individual hospital to years of extra expenditure having to buy, house, manage and support their own systems, which need costly support, training and loads of staff to look after. What a brilliant stroke that was!

  • rate this

    Comment number 269.

    @ sally 257

    i am sorry you feel that way, i was trying to get you to see my point of view without resorting to insults but appears you have tyaken it that way so i apologise, but i do think you should try to get to know someone before you accuse them condescension. this is far from reality with me.

  • rate this

    Comment number 268.

    Having lived overseas for a number of years it is astounding the complacency we have about the NHS in the UK, it has to be paid for! The reality is people are fitter and living longer, therefore we should require less treatment and different treatment from when the NHS was introduced therefore there must be room to restructure this public body get rid of out dated services & employ fewer people

  • rate this

    Comment number 267.

    Protect our NHS from Torie privatisation. You'll miss it when it's gone and you have to sell your worldly goods to have a broken arm fixed.

  • rate this

    Comment number 266.

    The BBC is mis-selling this story.

    What it's actually about is how the NHS killed patients through callousness and incompetence under Labour, when the money was flowing.

    Now care does seem to have improved, so presumably the NHS isn't killing people any more, which is nice of them.

    But the BBC is focussing on cuts - no wonder, given the pay-offs and waste in the BBC.

  • rate this

    Comment number 265.

    to much money wasted on IT projects that just get scrapped any they just it doesnt matter its public money plenty more were that came from,how about all the company cars that the nhs pay for and the free milk and all the lunches that we pay for when management have another meeting,
    look how much they spend on out sourceing like IT staff
    when if there staff got there back side they wouldnt need it

  • rate this

    Comment number 264.

    Of course the NHS has cash worries. Their funding gets cut, yet they're supposed to have better service whilst meeting targets and filling out reams of paperwork the gov require on top of the normal administration of a hospital.

    Add to that random fines for not meeting targets due to cutbacks and you get a problem where cash is the major concern. Something has to give there....

  • rate this

    Comment number 263.

    The funding problem arises because of the way the NHS is broken up. It is not 1 NHS but about 250 different organisations each with directors, boards and administrators. Hence when made redundant from 1 they can take the payoff and still work in the NHS. This is wasting billions.

  • rate this

    Comment number 262.

    We all have a view about how healthcare should be run yet how naive are those views.

    The NHS is GPs, Health Visitors, Hospitals, Mental Health, Ambulance services, Dentists, Opticians, Podiatrists, Physiotherapy...and many more.

    This costs £170 Bn a year to run.

    That's nearly £5,000 per year from very income I get value from my contribution?

  • rate this

    Comment number 261.

    Problems with lack of resources have not begun yet and will be formidable.

    I travelled a bus eatlier which broke down. It was good full of passengers. It took 10 minutes of silence and gradual migration from top deck before a majority realised it had broken down.

    Not only did the driver not speak English of one word, he does not understand it. There is a manager who needs sacking on this.

  • rate this

    Comment number 260.

    there are certain govt institutions that shouldnt HAVE to turn a profit and are too important to outsource.

    The NHS is one of them
    What does profit have to do with it? They are expected to operate as you or I and thats within our means. The problem is they don't, they get billions, spend even more and then that has to be paid by taxes as well

  • rate this

    Comment number 259.

    We need to wipe away decades of political bias and agenda & go back to the basic idea of an NHS that is free at the point of need (for everybody) providing the best possible care.

    It was formulated to ensure a healthy workforce, if the government wants to reduce those on disability benefit why not start with investing in the system that could help them?

    If a plant is wilting you water it.

  • rate this

    Comment number 258.

    Cash worries could harm the NHS. Some might content it already has and does.

  • Comment number 257.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 256.

    245. Whatever the NHS's problem is, it is not lack of funds. It has a colossal budget and we're all overtaxed as it is to pay for it.
    The NHS isn't expensive. See the scattergraph here;
    UK health spending and life expectency is OECD average. Bang/buck we're doing better than Denmark (but worse than France).


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