National Audit Office Points to Massive NHS Financial Failings

The National Audit Office has assessed the financial problems in the NHS as being endemic.

Despite the fact that the government has already promised extra funding for the health service, the National Audit Office believes that this provides no guarantee of recovery.

Vast levels of deficit are becoming normal practice according to the auditing organisation, and existing plans to boost the health budget will be insufficient to reverse the existing situation.

Last month, ministers unveiled plans to increase the NHS budget by £8.4bn above inflation in this Parliament.

But it is already known that the NHS faces a deficit of around £30 billion by the end of this decade.

This year, a deficit of more than £2bn is being forecast by NHS trusts.

Not only is this a massive figure, it also indicates the extent to which the situation is deteriorating.

The NHS ran up a significant budget deficit during the last financial year, but this figure was only just over £800 million.

Health ministers have suggested that most of this figure can be recovered by efficiency savings.

But the NAO said it was not clear if that would lead to stability.

In terms of creating a stabilised service, the National Audit Office suggested that the NHS England England five-year plan for reforming services will be absolutely essential.

The so-called Five-Year Forward View aims to save £22bn by 2020.

But the National Audit Office has poured scorn on this particular scheme, suggesting that it is reliant on untested plans for which there is limited evidence.

Overall, three-quarters of the 239 trusts were overspent at the half-year mark, with the most serious problems being seen in hospitals.

The National Audit Office paints a picture of an unsustainable situation in the health service, and one that could ultimately consume much of the budget increases allocated to the NHS.

Commenting on of the situation, the head of the National Audit Office, Amyas Morse, called on the government to take decisive action.

“Running a deficit seems to be becoming normal practice for acute trusts,” he said.

Meg Hillier, chair of the House of Commons’ Public Accounts Committee, said: “It is simply unacceptable. The strain placed on NHS trusts shows no sign of abating.”

Meanwhile, Health Minister David Prior defended the government’s accounting plans, and opined that the extra money for the NHS in the coming years indicated the commitment of the government to the NHS.

“Hospitals must now show tight financial grip and fully introduce our measures to reduce expensive temporary staffing and drive through the productivity and efficiency improvements,” Prior stated.

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GP Issues Highlighted by National Audit Office Report

A new report suggests that an increasing number of patients are unable to access their GP surgery for appointments.

The report conducted by the National Audit Office talks of an unacceptable access to care for patients across the United Kingdom.

In total, 27 per cent of patients experienced difficulties getting through to receptionists – a rise from 19 per cent in just three years, the National Audit Office discovered.

There was also an increase in the number of patients communicating dissatisfaction with the opening hours of doctors surgeries.

Difficulties in gaining access to a specific GP was also considered problematical.

The report found practices are unable to cope with rising patient demand, heaping pressures on overstretched Accident & Emergency departments.

Over 6 million patients every year are ultimately finding themselves in accident and emergency or other walk-in centres owing to the lack of available GP appointments.

Commenting on the issue, Roger Goss, from Patient Concern reflected that the existing situation is far from ideal.

“It is leaving patients in an extremely difficult situation. Each practice is a law unto itself, but all too often, you have to keep phoning in at 8am only to find that by the time you finally get through, all the slots are gone. Increasingly, we are finding patients have to wait three weeks for an appointment – no wonder they end up piling up at Accident & Emergency departments.”

Roughly 10 per cent of patients were unable to acquire an appointment at a GP surgery on their last attempt according to the National Audit Office.

Dr Maureen Baker, Chairman of the Royal College of GPs, is certainly concerned about this growing trend.

“This is most worrying because when a patient can’t make an appointment with their GP, we don’t know where they go; they might get better on their own; they might visit A&E where care is far more expensive; or they may simply stay sick”.

The National Audit Office report suggested that although people living in urban areas were likely to reside in relative proximity to a GP surgery, this was not reflected in rural areas.

Around 35 per cent of those currently living in rural areas do not have a surgery within 2 km of their home address.

Yet despite the lack of GP access, National Audit Office figures indicate that this is still an issue considered important by the general public.

The National Audit Office figures must be seen in the context of the government plans for the health service.

Prime Minister David Cameron has already indicated his intention to switch the NHS to what he has described as a 7-day culture.

This policy has been considered controversial by many doctors.

Katherine Murphy, chief executive of the Patients Association commented: “We need an NHS that understands that people have jobs and families to take care of. Much more must be done to ensure that they have access to GPs, particularly in the evenings and at the weekend. The variation in care highlighted in this report is unacceptable for patients.”

The report found that between 2011/12 and 2014/15, the percentage of patients who reported they were always able to see their preferred GP slid from 66 per cent to 60 per cent.

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Association of the British Pharmaceutical Association Responds to Audit Office Report

The Association of the British Pharmaceutical Association (ABPI) has responded to the recent report of the National Audit Office (NAO) with regard to this investigation into the Cancer Drugs Fund.

In its final report on the subject, the NAO concluded that there are major problems with regard to the fund in the immediate future.

It was asserted by the NAO that unless significant measures were taken to improve the funding of the Cancer Drugs Fund, numerous medicines would need to be removed from the list permanently.

Speaking about the assertions of the National Audit Office, Dr Richard Torbett, Executive Director, Commercial at the Association of the British Pharmaceutical Association, acknowledged that the audit office report should be considered an important document.

“We welcome this report which sheds an important light on the impact and the sustainability of the Cancer Drugs Fund and we are pleased to have had the opportunity to contribute our views,” Torbett stated.

Torbett also acknowledged that the situation in the United Kingdom with regard to cancer drugs is less than ideal.

“Whilst the Cancer Drugs Fund improved patient access to cancer medicines that are not routinely available on the NHS, the report makes clear that the use of new cancer drugs in the UK still remains below the average in other comparable countries. We remain adamant that this needs to change,” Torbett asserted.

Far from being in disagreement with the National Audit Office report, Torbett in fact acknowledge that legitimacy of conclusions made by the organisation.

“We want to see many more patients benefitting from new and innovative medicines, including cancer medicines, and we have long voiced the view that the Cancer Drugs Fund is not sustainable in its current form, as the NAO report highlights,” Torbett conceded.

Although there are clearly significant organisational, structural and financial problems faced by the fund in the medium-to-long-term, Torbett also suggested a potential resolution to the existing situation that could assist cancer patients across the United Kingdom.

“What is needed is a wholesale reform of NICE, which, along with NHS England, needs to develop a longer-term sustainable solution to the evaluation and commissioning of cancer medicines. We therefore look forward to the upcoming consultation on the Cancer Drugs Fund and remain committed to working with all parties to achieve a more joined-up system which allows many more NHS patients to benefit from life-enhancing medicines,” Torbett espoused.

It was reported in May 2015 that the total global spending on cancer drugs exceeded $100 billion in 2014.

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Cancer Drugs Fund Failing on Multiple Levels According to Audit Office

The National Audit Office (NAO) has documented the failure of the NHS to collect appropriate data on the cancer treatment outcome of a large raft of NHS patients related to the Cancer Drugs Fund.

In total, the National Health Service provided drugs to 74,000 cancer patients of whom the medicines regulator has no idea whether or not their lives were extended, according to the NAO.

This naturally indicates significant negligence on the behalf of the NHS, but also renders the statistical data related to cancer considerably less accurate.

According to Meg Hillier, chair of the public accounts committee, the failure to collect this wide variety of data simply makes no sense.

Furthermore, Hillier, who is a Labour MP, indicated that the oversight ensured that it is impossible to judge if the fund has indeed succeeded in extending the survival of patients, due to the gap in data.

In total, the NHS has funded in the region of £1 billion, providing cancer drugs for these 74,000 patients.

And in a report on the matter, the NAO was strongly critical of the NHS and Department of Health’s failure to collate adequate data.

The NAO describes the failure to collect information on the outcomes experienced by patients helped by the Cancer Drugs Fund as a major weakness of NHS operations.

In addition, an investigation by the public spending watchdog found that budgets for other NHS services have suffered as a result of spending on the fund.

The Cancer Drugs Fund attracts an annual budget of £416 million, since being set up by the coalition government back in 2010.

A plus point is that the fund has significantly improved access to 40 cancer drugs that are not usually readily available on the NHS.

This could enhance cancer survival rates regardless of the poor collection of data, with most recipients involved with Cancer Drug Fund requisition suffering from a terminal form of the disease.

Another notable success of the fund is that it underspent on its budget by 20 per cent overall.

However, this trend is unlikely to continue, as it is noted that spending has significantly increased in the last fiscal year.

Thus, the fund is anticipated to spend in the region of £70 million in 2015-16, according to NAO data.

“Taking 2013-14 and 2014-15 together, NHS England overspent the allocated budget for the fund by 35%. The overspend meant that less money was available for other services,” the NAO’s report on the fund states,

Commenting on the fund, the aforementioned Hillier indicated that a rethink was necessary owing to funding difficulties.

“At a time of increased pressures on NHS funding, the cancer drugs fund is not sustainable in its current form. There needs to be much better control of costs and proper assessment of whether these drugs are making a difference to the health of patients,” Hillier observed.

NHS England has already been forced to remove 28 drugs from the list of approved medicines that the fund is willing to pay for.

Cancer charities have warned that the withdrawals would mean the death of some patients awaiting medication, but NHS England has argued that inflated cost makes this decision inevitable.

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