NHS Financial Sustainability

Title: Robert White, Director, National Audit Office

Date: 18 January 2019

I’m Robert White, Director of Health, Value for Money Audit at the National Audit Office. Our recent report on the NHS Financial Sustainability found that there are depicts remaining right across the NHS in many organisations. Although the NHS balanced its budget overall because other organisations had surpluses many organisations went deeper into debt requiring a great deal of financial support. On top of that we also observed that waiting times for services deteriorated over the most recent years.

To address some of these challenges NHS England and the Department of Health brought together sustainability and transformation partnerships. These are groupings of local hospitals, ambulance services, mental health providers, local authority and other commissioners to plan services better. Decision making in those bodies is moving along but it is slow in some areas.

What we're recommending is that there needs to be a better grip of the demand for services and why that's occurring. We'd like to see a new payment system that supports integration and incentivises local bodies to do the right thing and we also think there needs to be clarity on the use of money to invest in new services.

There's great opportunity coming forward with the announcement of the long-term plan and the additional money the Prime Minister announced in June. But there are a number of other spending decisions that have yet to be made on social care, investment monies and education budgets. So more will be known in the spring but that money needs to be spent wisely and needs to address many of the challenges we identify in our report.

For more information on read our report online.