The Health Foundation’s response to The Forward View into action: planning for 2015/16

Today (Friday 19 December 2014) sees the launch of the NHS Planning Guidance for 2015/16 The Forward View into action: planning for 2015/16. The guidance sets out how NHS organisations will make a start towards achieving the vision set out in the Forward View in 2015/16.

The guidance clearly sets out the objective of accelerating the co-creation of new models of care as well as supporting spread and dissemination of those models through tailored approached to dealing with vanguard areas as well as those localities facing more challenges. The Health Foundation welcomes this approach alongside the commitment for greater coherence and joined-up working at the top across NHS England, Public Health England, the NHS Trust Development Authority, Monitor, the Care Quality Commission and Health Education England.

Dr Jennifer Dixon, Chief Executive of the Health Foundation, comments:

'The focus on accelerating change to improve quality of care and prevent ill health is welcome. The obvious question is how. The planning guidance makes useful suggestions, in particular to support new models of care and in areas that are struggling the most. But there now needs to be a coherent and evolving improvement strategy across the NHS. The ingredients of this include: scaling up quality improvement capability at the front line; a boost to operational excellence and managerial competence in providers; intelligent leadership willing to take calculated risks based on evidence; and a long-term policy environment which helps. Not all of this is in place yet, but it should be firmly developed over the next 5 years to support the ambition of the NHS Five Year Forward View - co-created between the service and the national ‘system stewards’.

'The Planning Guidance suggests that, while work will start in 2015/16 on building strong partnerships for future service transformation, the NHS will need to focus on achieving performance standards and will need to live within its financial means. This to-do list will be incredibly tough and the challenging financial situation facing the NHS next year should not be underestimated.'

In relation to the financial position, although the Planning Guidance recognises that the situation will continue to be very difficult, it does little to alleviate concerns that the 2015/16 financial year will be one of the toughest facing the NHS. The guidance talks openly about the challenge of meeting rising demand suggesting that GP referrals and non-elective activity are running at 12% and 9% above planned levels respectively. Against the background of rising demand, the document sets out the requirement for acute providers to agree plans setting out how they will make further progress to implement at least half of the ten clinical standards for seven day services. This will need to be done within existing resources. Additionally, it is expected that there will be a net decrease to the national tariff of 1.9% for 2015/16 (equivalent to an efficiency requirements of 3.8%).

Anita Charlesworth, Chief Economist at the Health Foundation, comments:

'We have known for some time that the 2015/16 financial year will be extremely tough for the NHS – one of the toughest in memory. This is why the Government committed more money for the health service in the Chancellor’s Autumn Statement. However, despite the injection of additional cash, the planning guidance issued by the NHS today shows that the financial situation for hospitals in the NHS remains precarious. Since 2011, the prices paid to hospitals under the national tariff system have fallen as part of the drive to deliver year on year efficiency savings. The planning guidance signals that the prices paid to NHS hospitals will fall by a further 1.9% next year. This is a bigger headline fall than in any of the previous 4 years. It is not at all clear how NHS hospitals will deliver savings on this scale. NHS hospitals are struggling this year with 80 per cent of acute hospitals in deficit when the reduction in their prices was 1.5%.

Media contact

Mike Findlay, Media Manager
T: 020 7257 8047
E: mike.findlay@health.org.uk