This document analyzes the financial climate facing NHS providers in England. It finds that NHS providers face rising costs and stagnant income growth. Provider deficits have increased in recent years. Tight funding limits have reduced spending on staff, capital projects, and training places. The combination of these financial pressures has created a "perfect storm" of challenges for NHS providers' finances.
These are the charts and figures from our briefing on what the UK leaving the EU might mean for funding of the NHS in England. We outline the current state of finances for NHS providers in 2015/16, what this implies for the total Department of Health budget, and the scale of the financial challenge facing the health service for the near future.
This slidepack contains figures and charts from analysis that is an update to the April 2015 Health Foundation report, 'Hospital finances and productivity: in critical condition?'
The analysis shows that the productivity of acute hospitals in England has continued to deteriorate. Overall, the productivity of acute hospitals increased by only 0.3% between 2009/10 and 2014/15 – an average rate of 0.1% per year. Between 2009/10 and 2014/15 as a whole, activity growth and input growth have converged leading to the very low level of annual average productivity growth.
NHS finances: the challenge all political parties need to face - updated tabl...The Health Foundation
View the full set of charts and tables from our 2015 briefing 'NHS finances: the challenge all political parties need to face' - some of the data was updated in May 2015 and this slidepack reflects those updates.
NHS finances: the challenge all policital parties need to face - charts and t...The Health Foundation
The NHS is one of the key issues of public concern in the run up to the 2015 general election and levels of concern have increased.
We have analysed the funding issues facing the NHS. This slidepack includes all the charts and tables from our research.
Find out more at wwww.health.org.uk/fundingbriefing
Mercer Capital's Value Focus: Laboratory Services | Mid-Year 2014Mercer Capital
Mercer Capital's Laboratory Services Industry newsletter provides perspective on valuation issues. Each newsletter also typically includes a macroeconomic trends, industry trends, and guideline public company metrics.
Anita Charlesworth: Trends in health spending & productivityNuffield Trust
In this audio slideshow, Anita Charlesworth, Chief Economist, Nuffield Trust, describes the key findings from our research examining patterns of spending on health, drawing on the accounts data of hundreds of strategic health authorities (SHAs), hospital and mental health trusts, and commissioning organisations dating back to 2003/4.
The full findings were published in the report: The anatomy of health spending 2011/12: a review of NHS expenditure and labour productivity (Nuffield Trust, March 2013), which forms part of an ongoing research programme the Nuffield Trust is undertaking, supported by PwC and McKesson.
These are the charts and figures from our briefing on what the UK leaving the EU might mean for funding of the NHS in England. We outline the current state of finances for NHS providers in 2015/16, what this implies for the total Department of Health budget, and the scale of the financial challenge facing the health service for the near future.
This slidepack contains figures and charts from analysis that is an update to the April 2015 Health Foundation report, 'Hospital finances and productivity: in critical condition?'
The analysis shows that the productivity of acute hospitals in England has continued to deteriorate. Overall, the productivity of acute hospitals increased by only 0.3% between 2009/10 and 2014/15 – an average rate of 0.1% per year. Between 2009/10 and 2014/15 as a whole, activity growth and input growth have converged leading to the very low level of annual average productivity growth.
NHS finances: the challenge all political parties need to face - updated tabl...The Health Foundation
View the full set of charts and tables from our 2015 briefing 'NHS finances: the challenge all political parties need to face' - some of the data was updated in May 2015 and this slidepack reflects those updates.
NHS finances: the challenge all policital parties need to face - charts and t...The Health Foundation
The NHS is one of the key issues of public concern in the run up to the 2015 general election and levels of concern have increased.
We have analysed the funding issues facing the NHS. This slidepack includes all the charts and tables from our research.
Find out more at wwww.health.org.uk/fundingbriefing
Mercer Capital's Value Focus: Laboratory Services | Mid-Year 2014Mercer Capital
Mercer Capital's Laboratory Services Industry newsletter provides perspective on valuation issues. Each newsletter also typically includes a macroeconomic trends, industry trends, and guideline public company metrics.
Anita Charlesworth: Trends in health spending & productivityNuffield Trust
In this audio slideshow, Anita Charlesworth, Chief Economist, Nuffield Trust, describes the key findings from our research examining patterns of spending on health, drawing on the accounts data of hundreds of strategic health authorities (SHAs), hospital and mental health trusts, and commissioning organisations dating back to 2003/4.
The full findings were published in the report: The anatomy of health spending 2011/12: a review of NHS expenditure and labour productivity (Nuffield Trust, March 2013), which forms part of an ongoing research programme the Nuffield Trust is undertaking, supported by PwC and McKesson.
These are the charts from a Health Foundation report where we examine the financial performance of NHS providers, focusing on hospitals.
We identify areas of cost pressure using their financial accounts up to 2013/14 and quarterly reporting data up to December 2014 (Q3 2014/15). We also examine trends in efficiency and productivity from 2009/10 to 2013/14.
www.health.org.uk
William behan analysis 2018 dper and tcd 2017 reports on general practiceDrWilliamBehan
A Critical Analysis of 2018 DPER report and 2017 TCD report on Irish General Practice Reviewing:
1. The public spend on general practice
2. The private spend on general practice
3. Points 1. and 2. deliver a total spend on Irish general practice
4. Comparison of the Irish annual payment per GMS patient and UK NHS payment
5. The mis-calculation of the UK nurse activity rates relative to Irish GP nurse workload
6. The extrapolated savings benefits from utilising nurse triage is unreliable.
7. Suggesting a lack of proof of the efficiency of Irish general practice is a result of the ignorance of the authors
Facts and Investment Opportunities in UK NHSChen Cao
This deck of presentation contains facts and investment opportunities in UK NHS after its newly restructuring, targeting on investors as primary audience base.
European Journal of Internal Medicine 32 (2016) e13–e14ConBetseyCalderon89
European Journal of Internal Medicine 32 (2016) e13–e14
Contents lists available at ScienceDirect
European Journal of Internal Medicine
journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor
No correlation between health care expenditure
and mortality in the European Union
0.0
0.5
1.0
1.5
2.0
2.5
1
9
9
8
2
0
0
0
2
0
0
2
2
0
0
4
2
0
0
6
2
0
0
8
2
0
1
0
2
0
1
2
2
0
1
4
Years
P
ro
c
a
p
it
a
e
xp
e
n
d
it
u
re
(
ra
ti
o
)
0.97
0.98
0.99
1
1.01
1.02
1.03
1.04
D
e
a
th
s
(m
ill
io
n
)
Expenditure
Mortality
0.95
1.00
1.05
0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4
Procapita expenditure ratio
D
e
a
th
r
a
tio
(a)
(b)
Fig. 1. Trends of aggregate health care expenditures and mortality in the European Union
from the year 2000 to the year 2013 (Fig. 1a), and correlation between variation of health
care expenditures and mortality over the same period normalized for data of the year 2000
(Fig. 1b).
Keywords:
Health care expenditure
Health care costs
Mortality
Deaths
There is ongoing debate about the impact of aggregate health care
expenditure on health outcomes, and it also remains quite uncertain
whether increasing health spending may be a significant factor for
decreasing death rates. In 1991, Mackenbach published an interesting
analysis to establish whether a higher national level of health care
expenditure could be associated with a larger degree of success in
decreasing mortality within the European Community [1], concluding
that no association existed between deaths and health care funding.
Interestingly, no other comprehensive evidence has been published
so far in Europe. Therefore, in order to establish whether or not any
relationship exists between aggregate health care expenditure and
mortality in the European Union in recent years, we analyzed data of
overall mortality in the 28 European countries from the year 2000 to
the year 2013, combined with those of the concomitant expenditure
for health care (all functions). Health care costs were reported as per
capita expenditure, including all financing agencies and all health care
providers (i.e., both private and public). Mortality data were extracted
from the official website of the European Union [2], whereas health
care costs were retrieved from the Organization for Economic Co-
operation and Development (OECD) [3]. For each year after the 2000,
a ratio was calculated for both mortality and health care expenditure
to normalize the data.
The results of our analysis are shown in Fig. 1. From the year 2000
to the year 2013, health care costs have constantly increased in the
countries of the European Union, nearly doubling at the end of the
observational period (Fig. 1a). At variance, the mortality trend did not
follow a consistent trend from the year 2000 to the year 2013, exhibiting
peaks (e.g., in the year 2003) and troughs (e.g., in the year 2004)
(Fig. 1a). When the ratio of health care expenditures and mortality of
each single y ...
International Investment Analysis: United KingdomMarlène Aimar
As part of my studies, I had to choose one country (the UK) and provide a thorough analysis of the chosen country.
In this presentation, you will find the opportunities existing in the country, the potential risks associated with the country (analysis of the BOP,, the the fluctuations in the exchange rate and the four major risks) and how to manage those risks (hedging currency risk, and reduce the other identified risks).
Mercer Capital's Value Focus: Healthcare Facilities | Year-End 2015 | Sub-Sec...Mercer Capital
Mercer Capital's Healthcare Facilities Industry newsletter provides perspective on valuation issues. Each newsletter also includes a macroeconomic trends, industry trends, and guideline public company metrics.
On Wednesday, 3 March 2021, ESRI researcher Conor Keegan presented the topic ‘Projections of expenditure for public hospitals in Ireland, 2018 to 2035’ at the conference ‘Irish hospital expenditure beyond the era of COVID-19.’
The conference examined issues relating to expenditure on acute hospital care in Ireland.
Findings from recent ESRI research, undertaken as part of the ESRI Research Programme in Healthcare Reform, which is funded by the Department of Health, were presented.
To view event details, click here: https://www.esri.ie/events/irish-hospital-expenditure-beyond-the-era-of-covid-19
To view a video of the presentation, click here: https://www.youtube.com/watch?v=mq6xCs2raOE
Financial pressures on the NHS are continuing to mount, with experts predicting a worrying £2 billion deficit in the NHS budget in 2015/16. With the supply of funding struggling to match growing demand, the NHS finds itself facing an unprecedented financial challenge.
This infographic pulls together the latest facts and figures on NHS finances and the pressures on its purse, painting a picture of a service at boiling point. The NHS Confederation is calling for a commitment from politicians for a ten-year spending settlement on the NHS to give members the space to release the pressure.
John Appleby, Chief Economist for The King's Fund, talks us through the productivity challenge facing the NHS, and discusses our new publication Improving NHS productivity: More with the same not more of the same.
A connected community working together to improve health and care quality across the UK. Presentation by Penny Pereira, Deputy Director of Improvement at the Health Foundation.
Q is an initiative, led by the Health Foundation and supported and co-funded by NHS England, connecting people skilled in improvement across the UK.
Q will make it easier for people from all parts of the health care system with expertise in improvement to share ideas, enhance their skills, and make changes that benefit patients.
More Related Content
Similar to A perfect storm: an impossible climate for NHS providers' finances? (Slidepack of all charts)
These are the charts from a Health Foundation report where we examine the financial performance of NHS providers, focusing on hospitals.
We identify areas of cost pressure using their financial accounts up to 2013/14 and quarterly reporting data up to December 2014 (Q3 2014/15). We also examine trends in efficiency and productivity from 2009/10 to 2013/14.
www.health.org.uk
William behan analysis 2018 dper and tcd 2017 reports on general practiceDrWilliamBehan
A Critical Analysis of 2018 DPER report and 2017 TCD report on Irish General Practice Reviewing:
1. The public spend on general practice
2. The private spend on general practice
3. Points 1. and 2. deliver a total spend on Irish general practice
4. Comparison of the Irish annual payment per GMS patient and UK NHS payment
5. The mis-calculation of the UK nurse activity rates relative to Irish GP nurse workload
6. The extrapolated savings benefits from utilising nurse triage is unreliable.
7. Suggesting a lack of proof of the efficiency of Irish general practice is a result of the ignorance of the authors
Facts and Investment Opportunities in UK NHSChen Cao
This deck of presentation contains facts and investment opportunities in UK NHS after its newly restructuring, targeting on investors as primary audience base.
European Journal of Internal Medicine 32 (2016) e13–e14ConBetseyCalderon89
European Journal of Internal Medicine 32 (2016) e13–e14
Contents lists available at ScienceDirect
European Journal of Internal Medicine
journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor
No correlation between health care expenditure
and mortality in the European Union
0.0
0.5
1.0
1.5
2.0
2.5
1
9
9
8
2
0
0
0
2
0
0
2
2
0
0
4
2
0
0
6
2
0
0
8
2
0
1
0
2
0
1
2
2
0
1
4
Years
P
ro
c
a
p
it
a
e
xp
e
n
d
it
u
re
(
ra
ti
o
)
0.97
0.98
0.99
1
1.01
1.02
1.03
1.04
D
e
a
th
s
(m
ill
io
n
)
Expenditure
Mortality
0.95
1.00
1.05
0.8 1.0 1.2 1.4 1.6 1.8 2.0 2.2 2.4
Procapita expenditure ratio
D
e
a
th
r
a
tio
(a)
(b)
Fig. 1. Trends of aggregate health care expenditures and mortality in the European Union
from the year 2000 to the year 2013 (Fig. 1a), and correlation between variation of health
care expenditures and mortality over the same period normalized for data of the year 2000
(Fig. 1b).
Keywords:
Health care expenditure
Health care costs
Mortality
Deaths
There is ongoing debate about the impact of aggregate health care
expenditure on health outcomes, and it also remains quite uncertain
whether increasing health spending may be a significant factor for
decreasing death rates. In 1991, Mackenbach published an interesting
analysis to establish whether a higher national level of health care
expenditure could be associated with a larger degree of success in
decreasing mortality within the European Community [1], concluding
that no association existed between deaths and health care funding.
Interestingly, no other comprehensive evidence has been published
so far in Europe. Therefore, in order to establish whether or not any
relationship exists between aggregate health care expenditure and
mortality in the European Union in recent years, we analyzed data of
overall mortality in the 28 European countries from the year 2000 to
the year 2013, combined with those of the concomitant expenditure
for health care (all functions). Health care costs were reported as per
capita expenditure, including all financing agencies and all health care
providers (i.e., both private and public). Mortality data were extracted
from the official website of the European Union [2], whereas health
care costs were retrieved from the Organization for Economic Co-
operation and Development (OECD) [3]. For each year after the 2000,
a ratio was calculated for both mortality and health care expenditure
to normalize the data.
The results of our analysis are shown in Fig. 1. From the year 2000
to the year 2013, health care costs have constantly increased in the
countries of the European Union, nearly doubling at the end of the
observational period (Fig. 1a). At variance, the mortality trend did not
follow a consistent trend from the year 2000 to the year 2013, exhibiting
peaks (e.g., in the year 2003) and troughs (e.g., in the year 2004)
(Fig. 1a). When the ratio of health care expenditures and mortality of
each single y ...
International Investment Analysis: United KingdomMarlène Aimar
As part of my studies, I had to choose one country (the UK) and provide a thorough analysis of the chosen country.
In this presentation, you will find the opportunities existing in the country, the potential risks associated with the country (analysis of the BOP,, the the fluctuations in the exchange rate and the four major risks) and how to manage those risks (hedging currency risk, and reduce the other identified risks).
Mercer Capital's Value Focus: Healthcare Facilities | Year-End 2015 | Sub-Sec...Mercer Capital
Mercer Capital's Healthcare Facilities Industry newsletter provides perspective on valuation issues. Each newsletter also includes a macroeconomic trends, industry trends, and guideline public company metrics.
On Wednesday, 3 March 2021, ESRI researcher Conor Keegan presented the topic ‘Projections of expenditure for public hospitals in Ireland, 2018 to 2035’ at the conference ‘Irish hospital expenditure beyond the era of COVID-19.’
The conference examined issues relating to expenditure on acute hospital care in Ireland.
Findings from recent ESRI research, undertaken as part of the ESRI Research Programme in Healthcare Reform, which is funded by the Department of Health, were presented.
To view event details, click here: https://www.esri.ie/events/irish-hospital-expenditure-beyond-the-era-of-covid-19
To view a video of the presentation, click here: https://www.youtube.com/watch?v=mq6xCs2raOE
Financial pressures on the NHS are continuing to mount, with experts predicting a worrying £2 billion deficit in the NHS budget in 2015/16. With the supply of funding struggling to match growing demand, the NHS finds itself facing an unprecedented financial challenge.
This infographic pulls together the latest facts and figures on NHS finances and the pressures on its purse, painting a picture of a service at boiling point. The NHS Confederation is calling for a commitment from politicians for a ten-year spending settlement on the NHS to give members the space to release the pressure.
John Appleby, Chief Economist for The King's Fund, talks us through the productivity challenge facing the NHS, and discusses our new publication Improving NHS productivity: More with the same not more of the same.
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A connected community working together to improve health and care quality across the UK. Presentation by Penny Pereira, Deputy Director of Improvement at the Health Foundation.
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With the NHS as the main area of public interest in the run-up to the 2015 general election, the Health Foundation and Ipsos MORI have conducted just under 1,800 interviews with adults across Great Britain to understand what the public thinks about the issues that are shaping debate on the NHS.
This presentation was given by our Chief Executive, Dr Jennifer Dixon, to the International Improvement Science and Research Symposium at the 2014 International Forum on Quality and Safety in Healthcare.
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This slide set shows the top level messages and findings from a report published by the Health Foundation and the Nuffield Trust, assessing the performance of the NHS on the quality of patient care in all four UK countries since devolution.
This presentation, by Professor Eugene Nelson from the Dartmouth Institute, looks at measuring what matters to patients and some specific case studies and examples.
To view a video of the presentation with sound/narrative, go to:
http://www.health.org.uk/multimedia/slideshow/measuring-what-matters-to-patients-concepts-and-cases/
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To view a video of the presentation with sound/narrative, go to:
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Does the framework in this report reflect your experience of healthcare?
Are there other dimensions of safety and how would this framework relate to them?
Would using this framework make it easier for you to know whether care is safe?
Please tell us how you could use this framework.
What do you think needs to be done to help you use the framework in practice?
How could the intelligence from the framework be used to improve care?
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To watch this presentation with accompanying audio/narration, go to:
http://www.health.org.uk/multimedia/slideshow/what-we-know-about-how-to-improve-quality-and-safety-in-hospitals/
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CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
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International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
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As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
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1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
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According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
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The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
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Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
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The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
A perfect storm: an impossible climate for NHS providers' finances? (Slidepack of all charts)
1. A perfect storm: an impossible climate for
NHS providers’ finances?
Sarah Lafond, Anita Charlesworth and Adam Roberts
March 2016
2.
3. Figure 1.1: Resource spending in real terms in England, 2014/15
(2015/16 prices, £bn)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
4. Table 1.1: Health Expenditure in England from
2009/10 to 2015/16 (2015/16 prices)
2009/10 2010-11 2011-12 2012-13 2013-14 2014-15
2015-16
(planned)
health expenditure, £110.2 £109.1 £110.1 £110.6 £113.0 £114.9 £116.4
annual change, real
terms (£bn) -0.9% 0.9% 0.5% 2.2% 1.7% 1.3%
health spending per
head £2,111 £2,073 £2,072 £2,067 £2,098 £2,116 £2,138
annual change, real
terms -1.8% 0.0% -0.3% 1.5% 0.9% 1.0%
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
5. Figure 2.1: Breakdown of NHS England increase spending,
2013/14 to 2014/15 (2015/16 prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
6. Figure 2.2: Commissioner spending, 2014/15, (2015/16 prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
7. Figure 2.3: Annual change in CCGs planned spending, 2013/14 to
2015/16, real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
8. Figure 2.4: Annual change in CCG planned spending by service
area, 2014/15 to 2015/16, real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
9. Figure 2.5: Breakdown of commissioner spending of non-NHS
providers, 2014/15 (2015/16 prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
10. Figure 2.6: Annual change in NHS commissioner spending on
care provided by non-NHS providers, 2013/14 to 2014/15, real
terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
11. Figure 2.7: Change in the proportion of commissioner spending
on non-NHS providers, real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
12. Table 3.1: Number of trusts as of March 31 2015
Type of trusts Number of trusts Percentage
Acute 137 57%
Ambulance 10 4%
Community 19 8%
Mental Health 56 23%
Specialist 19 8%
TOTAL 242
Note: This table excludes mergers and trusts that were dissolved
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
13. Figure 3.1: Net reported surplus/deficit for NHS providers
between 2012/13 and quarter 3 of 2015/16, £m (2015/16 prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
14. Figure 3.2: Number of trusts in deficit, 2012/13 to Q3 2015/16
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
15. Figure 3.3: Net deficit by region, 2012/13 to 2014/15 (2015/16
prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
16. Figure 3.4: Sources of NHS providers' 2014/15 operating income
and breakdown of £1.4bn annual change (2015/16 prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
17. Figure 3.5: Annual change in operating costs and income by type
of providers in real terms, 2013/14 to 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
18. Figure 3.6: Staff cost by type of employee (2015/16 prices)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
19. Figure 3.7: Annual change in staff cost by type, 2013/14 to
2014/15, real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
20. Figure 3.8: Skill mix of permanent and agency staff costs for
foundation trusts, Q1 of 2015/16 (£m)
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
21. Figure 3.9: Number of nurses employed in acute, general and
elderly sectors, excluding bank and agency staff.
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
22. Figure 3.10: Trends in nurse-to-patient ratio, admissions and
length of stay, 2010 to 2015
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
23. Figure 3.11: Agency staff cost as a percentage of total staff cost in
England
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
Area team code
Q44 Cheshire, Warrington & Wirral Q57 Essex
Q45 Durham, Darlington and Tees Q58 Hertfordshire and South Midlands
Q46 Greater Manchester Q59 Leicestershire and Lincolnshire
Q47 Lancashire Q60 Staffordshire & Shropshire
Q48 Merseyside Q64
Bath, Gloucestershire, Swindon and
Wiltshire
Q49
Cumbria, Northumberland, Tyne
&Wear Q65
Bristol, North Somerset, Somerset &
South Gloucestershire
Q50 North Yorkshire & Humber Q66 Devon Cornwall & Isles of Scilly
Q51 South Yorkshire & Bassetlaw Q67 Kent and Medway
Q52 West Yorkshire Q68 Surrey and Sussex
Q53
Arden, Herefordshire and
Worcestershire Q69 Thames Valley
Q54
Birmingham, Solihull and the
Black Country Q70 Wessex
Q55 Derbyshire & Nottinghamshire Q71 London
Q56 East Anglia
24. Figure 3.12: Employment status of chief executive of NHS
providers by type as of September 2015
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
25. Figure 3.13: Employment status of chief executive of NHS
providers in trusts in surplus and deficit
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
26. Table 3.2: Average annual increase in hospital
activity based on providers’ time series, 2008/09
-2015/16
2008/09-2010/11 2011/12-2014/15
Outpatient first attendances 5.3% 2.6%
Total admissions 3.0% 2.2%
of which:
non-elective 2.8% 1.7%
elective 3.2% 2.5%
A&E admissions 2.7% 2.3%
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
27. Figure 3.14: Change in CCGs’ planned activity for 2015/16
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
28. Figure 3.15: Proportion of income covered by tariff income by
size and type of acute trusts, 2012/13 and 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
29. Figure 3.16: Productivity, technical and allocative efficiency
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
30. Table 3.3: Change in cost adjustment factors of
national tariffs
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
2012/13 2013/14 2014/15
Cost uplift factor 2.2% 2.7% 2.5%
Efficiency
requirement
-4.0% -4.0% -4.0%
Total cost adjustment -1.8% -1.3% -1.5%
31. Figure 3.17: Change in hospital productivity, 2009/10 to 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
32. Figure 3.18: Annual change in hospital productivity index,
2009/10 to 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
33. Figure 3.19: Annual change in income from private patients,
2009/10 to 2014/15, in real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
34. Table 3.4 – Annual increase in hospital and
community health services (HCHS) pay and price
index and cost uplift factor (CUF), 2011/12 and
2014/15
HCHS pay and price index Cost Uplift Factor
2012/13 1.7% 2.2%
2013/14 1.1% 2.7%
2014/15 0.9% 2.5%
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
35. Figure 3.20: Annual average rate of income from private patients
from 2009/10 to 2014/15, real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
36. Table 4.1: Estimations of results of multivariate
regression model on net deficit as a proportion of
total cost (r^2 = 0.4597)
Variable1
Parameter estimate2
Standard error3
Specialist*** 0.02635 0.00788
Total number of hospital sites*** 0.000268 7.58E-05
Agency cost*** -0.37047 0.07524
Tariff income above average*** -0.014 0.00496
If a friend or relative needed treatment I would NOT be
happy with the standard of care provided by this
organisation(%)***
-0.00098 0.000432
Inadequate CQC rating* -0.02132 0.01129
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
[1]
*Significant at 90% confidence level, **Significant at 95% confidence level, ***Significant at 99% confidence level.
[2]
Parameter estimate refers to the variable coefficient. It indicates the nature of the relationship between the dependent variable (positive or negative) and the
linear dependence between tow variables
[3]
Standard error measures derivation from the mean
37. Figure 4.1: Net deficit and agency staff spend
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
38. Figure 4.2: Relationship between staff satisfaction with standard
of care and financial performance
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
39. Figure 4.3: Association between 66 hospitals’ financial position
and their CQC risk inspection rating, 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
40. Figure 4.4: Proportion of income from PbR tariff for acute
providers reporting a net deficit compared to providers
reporting net surplus, 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
41. Figure 5.1: The public-private hourly pay differential for workers
with similar characteristics
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
42. Table 5.1: University of York NHS productvity
estimates
Total Factor productivity
Growth (mixed method)
Total Factor productivity
Growth (indirect method)
2009/10 - 2010/11 3.2% 3.7%
2010/11 - 2011/12 2.1% 2.4%
2011/12 - 2012/13 0.4% -0.3%
2012/13 - 2013/14 2.2% 2.1%
Annual average 2004/05 to
2013/14
1.4% 1.4%
Annual average 2009/10 to
2013/14
2.0% 2.0%
Source: Bojke et al 2016
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
43. Table 5.2 NHS QIPP savings 2011-12 to 2014/15
Year Outturn/forecast Saving (£ bn),
cash terms
Saving (£ bn)
2015/16 prices
2011-12 Outturn 5.8 5.9
2012-13 Outturn 5.0 5.1
2013-14 Outturn 4.3 4.4
2014-15 Outturn 1.8 1.8
TOTAL 16.9 17.1
Source: correspondence with NHS England on 04/02/2016
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
44. Figure 5.2: Number of training places commissioners for clinical
staff, 2004/05 to 2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
45. Figure 5.3: Annual change in NHS spend per head in
England, in real terms
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
46. Figure 5.4: Variation in productivity of hospital, 2009/10 to
2014/15
March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
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March 2016 A perfect storm: an impossible climate for NHS providers’ finances?
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March 2016 A perfect storm: an impossible climate for NHS providers’ finances?