Spending on Health 2011-2015Anita CharlesworthChief EconomistThe Nuffield TrustMay 2011                       © Nuffield T...
Overall Government Spending Plans             Government Spending Plans (£ billion)                          2014-15    20...
Health in a privileged Position• Overall Health Funding increasing by 0.1% per annum on  average over CSR                 ...
The Scale of the Challenge       14.0%                Annual real terms growth in UK public spending on health       12.0%...
Health Spending                        UK Public Health Spending as a share of GDP 10.0  9.0  8.0  7.0  6.0  5.0  4.0  3.0...
What is the money buying?                                                       Primary Care,                             ...
The Efficiency Challenge (£ million)                                       © Nuffield Trust
The Productivity Story so far                Productivity growth in health and the general economy 4.00 3.00 2.00 1.00 0.0...
What will the NHS do? 2010-11 to 2013-14 • Control pay with the settlement freeze for all staff earning more   than £21,00...
NHS Costs                                       Share of HCHS Expenditure  60.0%  50.0%  40.0%  30.0%  20.0%  10.0%   0.0%...
Spending Pressures                A comparison of Health Service Pay and Price Inflation                                an...
Quality, Innovation, Productivity and Prevention (QIPP)                        • Safe care and right care (e.g. reducing p...
Better Care, Better Value Productivity Savings Estimates           Managing 14 Day Readmission Rates          £99,560,000 ...
www.nuffieldtrust.org.uk       Sign-up for our newsletter       www.nuffieldtrust.org.uk/newsletter       Follow us on Twi...
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Anita Charlesworth: Spending on Health 2011-2015

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Anita Charlesworth: Spending on Health 2011-2015

  1. 1. Spending on Health 2011-2015Anita CharlesworthChief EconomistThe Nuffield TrustMay 2011 © Nuffield Trust
  2. 2. Overall Government Spending Plans Government Spending Plans (£ billion) 2014-15 2010-11 £114 Health £104 £389 DEL £394 £384 AME £302 £740 TME £697May 2011 © Nuffield Trust
  3. 3. Health in a privileged Position• Overall Health Funding increasing by 0.1% per annum on average over CSR 2010-11 2014-15 Real terms change Resource £98.7bn £109.8bn 1.3% DEL Capital DEL £5.1bn £4.6bn -17% Overall DEL £103.8bn £114.4bn 0.4%May 2011 © Nuffield Trust
  4. 4. The Scale of the Challenge 14.0% Annual real terms growth in UK public spending on health 12.0% Real terms growth population growth 10.0% growth in 80 plus population 8.0% 6.0% 4.0% 2.0% 0.0% -2.0% -4.0% -6.0% © Nuffield TrustSource: Nuffield Trust (IFS and HMT data)
  5. 5. Health Spending UK Public Health Spending as a share of GDP 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 % of GDP © Nuffield TrustSource: Nuffield Trust (IFS and HMT data)
  6. 6. What is the money buying? Primary Care, 11% Prescribing, 12% General and acute, 44% Other, 4% Community health Services and learning difficulties, 12% Mental Health, A%E, 3% 11% Maternity, 3% © Nuffield TrustSource: Nuffield Trust analysis of DH data
  7. 7. The Efficiency Challenge (£ million) © Nuffield Trust
  8. 8. The Productivity Story so far Productivity growth in health and the general economy 4.00 3.00 2.00 1.00 0.00 -1.00 -2.00 -3.00 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Health Whole Economy Source: ONS © Nuffield Trust
  9. 9. What will the NHS do? 2010-11 to 2013-14 • Control pay with the settlement freeze for all staff earning more than £21,000 • Bear down on hospital efficiency through a tight framework for prices (PBR) • Implement the QIPP programme • Reduce management costs 11-12 12-13 13-14 14-15 Cumulative real terms savings Reduction £600m £1.1bn £1.4bn £1.4bn 33% © Nuffield Trust
  10. 10. NHS Costs Share of HCHS Expenditure 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% staff M&D non pay capital chargeSource: Nuffield Trust analysis of DH data © Nuffield Trust
  11. 11. Spending Pressures A comparison of Health Service Pay and Price Inflation and the GDP Deflator 6 5 4 3 2 1 0 NHS Pay and Prices GDP Deflator © Nuffield TrustSource: DH and HMT
  12. 12. Quality, Innovation, Productivity and Prevention (QIPP) • Safe care and right care (e.g. reducing pressure sores) Commissioning • Long-term conditions and pathways • Urgent and emergency care (aim for a 10% reduction in A%E attendances) • End of life care (Birmingham pilot £1m pa saving) • Back office efficiency and optimal management (£600m) Provider • Procurement • Clinical support (Pathology services £500m p.a.) efficiency • Productive care (focused on lean production techniques) • Medicine use and procurement System • Primary care commissioning enablers • Technology and digital vision © Nuffield Trust
  13. 13. Better Care, Better Value Productivity Savings Estimates Managing 14 Day Readmission Rates £99,560,000 Reducing Follow-up Appointments £232,070,000 Productivity Reducing DNA Rate £190,000,000 savings of Percentage of Low Cost Statin Prescribing £72,740,000 £3 billion a year possible Managing Variations in Outpatient Appointments £260,000,000 (NHS Institute for Improvement) Managing Varitaion in Emergency Admissions £335,600,000 Managing Variations in Surgical Thresholds £91,300,000 Reducing Pre-Operative Bed Days £712,000,000 Increasing Day Case Surgery Rate £17,000,000 Reducing Length of Stay £1,005,000,000 © Nuffield Trust
  14. 14. www.nuffieldtrust.org.uk Sign-up for our newsletter www.nuffieldtrust.org.uk/newsletter Follow us on Twitter (http://twitter.com/NuffieldTrust)May 2011 © Nuffield Trust

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