1. Pressures on hospital service provision
A key element of ensuring robust financial planning in the medium and long
term is to shift the focus to prevention rather than cure. The PCT needs to
ensure that it spends its limited resources in those areas which demonstrate
the best outcomes to ensure maximum value for money. Again there is a clear
synergy with the PCT’s focus on health improvement and reducing
inequalities. Value for money is therefore defined in terms of economy,
efficiency and effectiveness.
A key financial risk is the acute activity growth which has often exceeded the
growth in resources. This has been exacerbated by the need to invest in the
achievement of the 18 weeks target, the additional activity that has been seen
due to higher referrals that are the consequence of the reduction in waiting
times, and the increasing expectations of the population.
Current hospital activity shows that patients being admitted to hospital could
and should be cared for in their own home or in more accessible community
settings. In particular, people with long-term ill health are frequent attendees
at hospital accident and emergency departments and often have several
hospital admissions every year. Compelling evidence suggests that many of
these attendances could be avoided if people were proactively supported and
treated by community services
There have been changes to working time directives for doctors. In order to
maintain current service levels Barnet and Chase Farm hospitals will need to
recruit an unrealistic number of doctors. Furthermore, hospital services have
been identified as being under threat as a result of new regulations such as
Accident and emergency and women and children’s services ie. maternity and
paediatrics
It is true to say that hospital treatment is becoming increasingly specialised
and there is overwhelming evidence that patients with the most serious
illnesses are best treated in specialist centres.