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A perfect storm: an impossible climate for NHS providers’ finances?

A perfect storm: an impossible climate for NHS providers’ finances?. Sarah Lafond, Anita Charlesworth and Adam Roberts. March 2016. Figure 1.1: Resource spending in real terms in England, 2014/15 (2015/16 prices, £bn).

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A perfect storm: an impossible climate for NHS providers’ finances?

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  1. A perfect storm: an impossible climate for NHS providers’ finances? Sarah Lafond, Anita Charlesworth and Adam Roberts March 2016

  2. A perfect storm: an impossible climate for NHS providers’ finances? Figure 1.1: Resource spending in real terms in England, 2014/15 (2015/16 prices, £bn)

  3. A perfect storm: an impossible climate for NHS providers’ finances? Table 1.1: Health Expenditure in England from 2009/10 to 2015/16 (2015/16 prices)

  4. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.1: Breakdown of NHS England increase spending, 2013/14 to 2014/15 (2015/16 prices)

  5. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.2: Commissioner spending, 2014/15, (2015/16 prices)

  6. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.3: Annual change in CCGs planned spending, 2013/14 to 2015/16, real terms

  7. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.4: Annual change in CCG planned spending by service area, 2014/15 to 2015/16, real terms

  8. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.5: Breakdown of commissioner spending of non-NHS providers, 2014/15 (2015/16 prices)

  9. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.6: Annual change in NHS commissioner spending on care provided by non-NHS providers, 2013/14 to 2014/15, real terms

  10. A perfect storm: an impossible climate for NHS providers’ finances? Figure 2.7: Change in the proportion of commissioner spending on non-NHS providers, real terms

  11. A perfect storm: an impossible climate for NHS providers’ finances? Table 3.1: Number of trusts as of March 31 2015 

  12. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.1: Net reported surplus/deficit for NHS providers between 2012/13 and quarter 3 of 2015/16, £m (2015/16 prices)

  13. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.2: Number of trusts in deficit, 2012/13 to Q3 2015/16

  14. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.3: Net deficit by region, 2012/13 to 2014/15 (2015/16 prices)

  15. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.4: Sources of NHS providers' 2014/15 operating income and breakdown of £1.4bn annual change (2015/16 prices)

  16. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.5: Annual change in operating costs and income by type of providers in real terms, 2013/14 to 2014/15

  17. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.6: Staff cost by type of employee (2015/16 prices)

  18. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.7: Annual change in staff cost by type, 2013/14 to 2014/15, real terms

  19. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.8: Skill mix of permanent and agency staff costs for foundation trusts, Q1 of 2015/16 (£m)

  20. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.9: Number of nurses employed in acute, general and elderly sectors, excluding bank and agency staff.

  21. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.10: Trends in nurse-to-patient ratio, admissions and length of stay, 2010 to 2015

  22. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.11: Agency staff cost as a percentage of total staff cost in England

  23. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.12: Employment status of chief executive of NHS providers by type as of September 2015

  24. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.13: Employment status of chief executive of NHS providers in trusts in surplus and deficit

  25. A perfect storm: an impossible climate for NHS providers’ finances? Table 3.2: Average annual increase in hospital activity based on providers’ time series, 2008/09 -2015/16

  26. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.14: Change in CCGs’ planned activity for 2015/16

  27. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.15: Proportion of income covered by tariff income by size and type of acute trusts, 2012/13 and 2014/15

  28. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.16: Productivity, technical and allocative efficiency

  29. A perfect storm: an impossible climate for NHS providers’ finances? Table 3.3: Change in cost adjustment factors of national tariffs

  30. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.17: Change in hospital productivity, 2009/10 to 2014/15

  31. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.18: Annual change in hospital productivity index, 2009/10 to 2014/15

  32. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.19: Annual change in income from private patients, 2009/10 to 2014/15, in real terms

  33. A perfect storm: an impossible climate for NHS providers’ finances? 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

  34. A perfect storm: an impossible climate for NHS providers’ finances? Figure 3.20: Annual average rate of income from private patients from 2009/10 to 2014/15, real terms

  35. A perfect storm: an impossible climate for NHS providers’ finances? Table 4.1: Estimations of results of multivariate regression model on net deficit as a proportion of total cost (r^2 = 0.4597) [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

  36. A perfect storm: an impossible climate for NHS providers’ finances? Figure 4.1: Net deficit and agency staff spend

  37. A perfect storm: an impossible climate for NHS providers’ finances? Figure 4.2: Relationship between staff satisfaction with standard of care and financial performance

  38. A perfect storm: an impossible climate for NHS providers’ finances? Figure 4.3: Association between 66 hospitals’ financial position and their CQC risk inspection rating, 2014/15

  39. A perfect storm: an impossible climate for NHS providers’ finances? Figure 4.4: Proportion of income from PbR tariff for acute providers reporting a net deficit compared to providers reporting net surplus, 2014/15

  40. A perfect storm: an impossible climate for NHS providers’ finances? Figure 5.1: The public-private hourly pay differential for workers with similar characteristics

  41. A perfect storm: an impossible climate for NHS providers’ finances? Table 5.1: University of York NHS productvity estimates

  42. A perfect storm: an impossible climate for NHS providers’ finances? Table 5.2 NHS QIPP savings 2011-12 to 2014/15

  43. A perfect storm: an impossible climate for NHS providers’ finances? Figure 5.2: Number of training places commissioners for clinical staff, 2004/05 to 2014/15

  44. A perfect storm: an impossible climate for NHS providers’ finances? Figure 5.3: Annual change in NHS spend per head in England, in real terms

  45. A perfect storm: an impossible climate for NHS providers’ finances? Figure 5.4: Variation in productivity of hospital, 2009/10 to 2014/15

  46. Find out more at www.health.org.uk/perfectstorm

  47. A perfect storm: an impossible climate for NHS providers’ finances? The Health Foundation is an independent charity committed to bringing about better health and health care for peoplein the UK. We connect what works on the ground witheffective policymaking and vice versa.

  48. A perfect storm: an impossible climate for NHS providers’ finances? • Subscribe to our email newsletter • Register for email alerts to be notified about our latest work • Follow us on Twitter,Facebook, youTubeor Linkedin

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