I help NHS orgs embrace digital & innovate ➕ I help healthtech fit the NHS. National advisor. Social enterprise advocate, founder & non-exec. I write about #digitalhealth on LinkedIn.
Another hard hitting update on the desperate financial state of local NHS systems. Now 75% of ICS' unable to balance budgets for 24/25. Will impact anyone in #digitalhealth and #healthtech - deets below 👇 In latest HSJ update 31 out of 42 ICSs planning deficits this financial year. That is the highest figure I've seen to date, and up until now I was quoting over half at 25/42. NHS England providing £2.2bn to cover local budget gaps. Systems already behind financial plans in first two months of the financial year (which runs April to March). Total system spend £300m off plan by end of May. No shock there. 11 additional ICSs warned of "significant concern" about finances. They are Bath and North East Somerset, Swindon and Wiltshire; Buckinghamshire, Oxfordshire and Berkshire West; Coventry and Warwickshire; Devon; Dorset; Hertfordshire and West Essex; Humber and North Yorkshire; Northamptonshire; South West London; Staffordshire and Stoke on Trent; and Sussex. 9 highest-risk ICSs ordered to bring in consultants for efficiency review. I covered this in a recent post - https://lnkd.in/e_c86X43 Costs in prescribing and NHS-funded care packages increasing faster than allocations. Given the meds budget is around 19bn per year and hard to control, uncontrollable growth can easily swallow the extra investment promised. Agency staff spending reduced to £3bn in 2023-24, down £500m from previous year. This year I think it's going to be much lower, although sources suggest that it's now flowing through 'service integrators' (consultancy groups) who are the only option for many and significantly more expensive than the contractors. Providers aim to further reduce agency spending to less than £2.5bn, but as above I think this will be a false number. New finance rating system is being implemented to monitor ICS performance. Financial rules overhauled in May 2024 with harsher penalties for unbalanced budgets. So in other words more financial penalties for not slashing care enough to meet the national pressures foisted upon them. This. Is. An. Unsustainable. Crisis. #NHSFinance #IntegratedCareSystems #HealthcareManagement
Carl Armstrong
7mo
That point about agency staff is an interesting one. The main concern I receive from senior Leadership at Trust level is about cost of 'agency' resource. As you rightly point out Liam Cahill, that money is increasingly going to established Service Integrators/Consultancies. We're winning work where, if I compare our rate card against some of the established Service Integrators/Consultancies in our particular niche, it is much more cost-effective for a Trust to utilise our service over theirs. Trusts can very easily realise a 30%+ saving on resource us than they would via a Service Integrator/Consultancy. Trusts are very quick to make us aware that they are struggling massively with funding. Every single one of us is very well aware of that fact. Then those Trusts procure services where they're paying 50% extra for it. And then those Consultancies will regularly utilise our services to hire additional skills when needed. The benefit of using our services is that we can perform the role of a Consultancy but at the price point of an Agency. I'll point to the extensive work Futures has done in Social Care implementations (we've worked with over 90% of Councils in England) for Liquidlogic or Mosaic implementations.
Guillaume Leroux
7mo
For digital health, this mean heightened pressure to understand, monitor, evaluate and optimise technology benefits, impacts and outcomes. Budgets will remain in the red for a looong time. Measuring health outcomes, in particular digital, via the quintuple aims might be more productive. Yet, consistent implementation of benefits evaluation is still nascent in digital health and the quality and safety workforce skills and competencies are yet to keep up with the progress. Let's hope this situation won't lead to more failed digital health pilot interventions never scaling up. This would only create more waste in an already wasted healthcare landscape.
Laura Johnson
7mo
😫 I don't even know now what can be done to turn around the NHS crisis. It is actually heartbreaking and maddening to see such massive mismanagement and yet still the people on the ground will keep showing up to work and caring for those who are sick.
Lloyd Price
7mo
Good work Liam :)
Utterly bonkers! Pre-2010 even proposing a deficit in an NHS organisation would make a CEO or FD’s position “untenable”. How did we get into this awful predicament?
Healthcare Consultant | Programme Manager | Project Manager | Co-production Facilitator | Coaching and Mentoring
7mo"Agency staff spending reduced to £3bn in 2023-24. This year ......... much lower ...... flowing through 'service integrators' (consultancy groups) ..... significantly more expensive than the contractors. .... further reduce agency spending to less than £2.5bn ..... ", Not only do these consultancy groups cost more in terms of outlay, but they don't deliver actual results/ outcomes which are comparable to individual interims, if they deliver anything at all. It's an absolute disgrace that there are NHS leaders who are making these decisions and simply lining the pockets of the Big 4 whilst many interims are either unemployed or have moved sectors. This purge on finance has simply created toxic environments occupied by disillusioned and tired staff, strained services resulting in stressed and/or increasingly debilitated patients. When are we going to see a radical approach like, say, delivering high quality services which meet patient needs, improving workplace culture, development opportunities for staff, linking in with all the other critical services such as social care and housing which impact on people's health and wellbeing. Financial management of the NHS is not only killing it, but destroying lives.