A new report by MPs suggests that plans to move NHS care out of hospitals into community and primary care settings are being undermined by financial difficulties.
The study has been authored by the House of Commons Public Accounts Committee, and the organisation suggests that the continuing deterioration in NHS finances is simply unsustainable.
And the financial situation across the health service has worsened considerably since previous reports were filed in 2015 and last year, according to the latest views of the committee.
Multiple hospital trusts face severe financial difficulty, with the situation getting worse rather than better.
The warnings can be considered particularly timely considering that NHS Improvement has recently warned that NHS trusts are heading for a deficit in the region of £800 million by the end of the existing financial year.
Meanwhile, the British Medical Association has already warned that sustainability and transformation plans are unworkable due to the funding gap.
This view was echoed by the King’s Fund, which believes that the lack of a mechanism for upfront investment in community services is conspicuous by its absence.
MPs on the Public Accounts Committee were largely in agreement with these views, asserting that there is a considerable distance to traverse before the public can feel confident in the Sustainability and Transformation Programme.
At present, this policy is generally viewed as a mechanism for cutting services, rather than a legitimate evolution of the health service.
“To reduce the demand for expensive hospital care, the NHS needs to invest in alternative care models, such as primary and community services. But NHS England told us that us that the deficits in trusts mean there is £800m less money in 2016/17 to invest in out-of-hospital care and offset the increases in demand,” the report asserts.
Commenting on the report, Public Accounts Committee chair Meg Hillier, the MP for Lab, Hackney South and Shoreditch, suggested that the existing situation is extremely serious.
“The NHS as we know it is under threat from growing and unsustainable financial pressures. Few trusts feel they have a credible plan for meeting the financial targets they have been set by government. At the same time, the government seems unable to get its own house in order – plundering NHS investment funds to plug holes elsewhere, and falling out in public over its longer-term strategy”.
Hillier also asserted that the government has failed to tackle the crisis adequately.
“Contradictory statements about funding from the prime minister and head of NHS England are an insult to taxpayers who deserve an honest, grown-up conversation about future finance and service provision. It is inconceivable the government would allow a catastrophic failure in the NHS and we expect it to take targeted action now to support NHS bodies facing severe financial problems.”
BMA chair Dr Mark Porter was very much in agreement with Hillier, asserting that the Sustainability and Transformation Programme is fundamentally failing.
“These MPs are the latest in a long line of people growing sceptical about the success of STPs. We already know that the vital funding needed to carry out these plans simply isn’t available. The simple fact is that the NHS is at breaking point because politicians have chosen to underfund our health and social care system and ignore the warnings of healthcare professionals. Tragically it is our patients who are unfairly suffering the consequences of these bad choices.”