Small and medium-sized district general hospitals and trusts with large private finance initiatives look the most vulnerable claims a new report from Monitor, the Independent Regulator of NHS Foundations Trusts. Front-line services look set to take a hit.
Of 20 small acute trusts, six are in significant breach says Monitor while just 14 out of 41 mental health foundation trusts are now regarded as at low financial risk. Monitor does say that, short-term, the sector's balance sheet looks positive. But it's the longer term picture that's more worrying.
"Monitor's review," says Chief Operating Officer, Stephen Hay, "suggests that an increasing number of individual trusts will face financial difficulties by the end of this period, with different issues affecting different trusts."
Previous targets of four hours to be treated in A&E - quite a wait for many in severe pain - and hospital treatment within 18 weeks if referred by a doctor now look threatened. The freeze in NHS spending planned for 2010−11 to 2014−15 would, if delivered, be the tightest four year period of NHS funding in fifty years claims the Nuffield Trust.
Back of the queue?
Carl Emmerson, deputy director of the Institute for Fiscal Studies, agrees. The last decade, he says, "saw the NHS receive large increases in its funding but the outlook for the 2010s is in sharp contrast to this."
Not keeping paceDavid Cameron, says Labour Shadow Health Secretary Andy Burnham, has cut the NHS budget for two years running "and we are now seeing the effects of this on the ground in the NHS. On his watch, we have seen the NHS lose nurses at a rate of 200 per month as hospital trusts make knee jerk cuts to the frontline."
"This explains why hospitals are under intense pressure with waiting lists rising and patients being forced to wait on trolleys."