The NHS have recently published a document titled ‘NHS Five Year Forward View’, the document can be downloaded directly from nhs.uk here. The Executive Summary outlines the aims of the document:
1. The NHS has dramatically improved over the past fifteen years.
Cancer and cardiac outcomes are better; waits are shorter; patient
satisfaction much higher. Progress has continued even during global
recession and austerity thanks to protected funding and the
commitment of NHS staff. But quality of care can be variable,
preventable illness is widespread, health inequalities deep-rooted.
Our patients’ needs are changing, new treatment options are
emerging, and we face particular challenges in areas such as mental
health, cancer and support for frail older patients. Service pressures
are building.2. Fortunately there is now quite broad consensus on what a better
future should be. This ‘Forward View’ sets out a clear direction for
the NHS – showing why change is needed and what it will look like.
Some of what is needed can be brought about by the NHS itself. Other
actions require new partnerships with local communities, local
authorities and employers. Some critical decisions – for example on
investment, on various public health measures, and on local service
changes – will need explicit support from the next government.
Towards the end of the document are suggested scenarios on future funding and investment models for the NHS:
We will drive efficiency and productive investment
It has previously been calculated by Monitor, separately by NHS England,
and also by independent analysts, that a combination of a) growing
demand, b) no further annual efficiencies, and c) flat real terms funding
could, by 2020/21, produce a mismatch between resources and patient
needs of nearly £30 billion a year.So to sustain a comprehensive high-quality NHS, action will be needed on
all three fronts. Less impact on any one of them will require compensating
action on the other two.
…
Funding
NHS spending has been protected over the past five years, and this has
helped sustain services. However, pressures are building. In terms of
future funding scenarios, flat real terms NHS spending overall would
represent a continuation of current budget protection. Flat real terms NHS
spending per person would take account of population growth. Flat NHS
spending as a share of GDP would differ from the long term trend in which
health spending in industrialised countries tends to rise a share of
national income.Depending on the combined efficiency and funding option pursued, the
effect is to close the £30 billion gap by one third, one half, or all the way.• In scenario one, the NHS budget remains flat in real terms from
2015/16 to 2020/21, and the NHS delivers its long run productivity
gain of 0.8% a year. The combined effect is that the £30 billion gap in
2020/21 is cut by about a third, to £21 billion.• In scenario two, the NHS budget still remains flat in real terms over
the period, but the NHS delivers stronger efficiencies of 1.5% a year.
The combined effect is that the £30 billion gap in 2020/21 is halved,
to £16 billion.• In scenario three, the NHS gets the needed infrastructure and
operating investment to rapidly move to the new care models and
ways of working described in this Forward View, which in turn
enables demand and efficiency gains worth 2%-3% net each year.Combined with staged funding increases close to ‘flat real per person’
the £30 billion gap is closed by 2020/21.Decisions on these options will inevitably need to be taken in the context
of how the UK economy overall is performing, during the next Parliament.
However nothing in the analysis above suggests that continuing with a
comprehensive tax-funded NHS is intrinsically undoable – instead it
suggests that there are viable options for sustaining and improving the
NHS over the next five years, provided that the NHS does its part, together
with the support of government. The result would be a far better future
for the NHS, its patients, its staff and those who support them.
Plaintext Link: http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf