NHS commissioners on course for some ‘unpalatable’ decisions

But UNISON warns that ‘there is little left to cut’

The NHS in England will struggle to meet the government requirement to save £22bn by 2020, according to a new report by independent health charity The Nuffield Trust.

The trust’s analysis suggests that even if hospitals and other NHS providers made cost savings of 2% a year, as they are at present, the funding gap would still stand at around £6 billion by 2020–21.

The consequences could be disastrous for services.

The £22bn target was established by NHS England’s Five Year Forward View, published in 2014.

For the most part, the task of closing the health service’s funding gap is expected to be borne by healthcare providers making efficiency savings.

But their efforts cannot plug the hole alone.

At the same time, demand on NHS services is growing. The NHS is relying on new models of care to curb the growth in activity and treat patients more cheaply.

The Nuffield report, Feeling the crunch: NHS Finances to 2020, states that if NHS commissioners fail in their attempts to reduce the rate at which demand is growing, or if additional funding cannot be secured, “the NHS will face some unpalatable decisions in order to curb the growth in activity and bring the books into balance”.

These could include extending waiting times for treatment, raising the threshold at which patients become eligible for treatment, cutting some services altogether, or closing whole sites or hospitals.

UNISON head of health Christina McAnea commented today: “UNISON pointed out from the start that the drive for £22bn of so-called ‘efficiency savings’ was unachievable.

“Of course the NHS should always look to improve the way it delivers services. But international comparisons show that we already have one of the most efficient healthcare systems anywhere in the world.

“The level of efficiencies demanded has never been attempted anywhere before. The simple fact is that previous, similar initiatives mean there is little left to cut if the NHS is to continue delivering the highest quality care.”