Pessimism growing as financial pressures mount

The report has, for the first time, included a survey of directors of adult social services in English local authorities alongside the usual survey of NHS finance directors. Both surveys suggest that the financial squeeze is beginning to have an impact on quality and access to services in some parts of the country. One-third of NHS finance directors have reported that the quality of patient care has worsened during the last year and more than one-third of social services directors expect to have to cut social care services over the next year. While most NHS organisations are on track to meet financial targets, it is clear that pressures are growing towards the end of the second year of the ‘Nicholson Challenge’ to find £20 billion in productivity improvements by 2015. With local authorities grappling with the second year of a budget squeeze that will see an overall cut of 27% in central Government funding by 2015, directors of adult social services are pessimistic about the financial outlook. The report also includes a dashboard of key NHS performance indicators. While these are mostly stable, the proportion of patients waiting more than four hours in A&E is at its highest level for this quarter since 2003/4. This remains within the Government’s target range, with the increase to some extent accounted for by the relaxation in the target and seasonal factors. However, with more than 25% of Trusts reporting breaches of the target, it is clear that many hospitals are struggling to maintain performance in emergency care. According to the official statistics, delays in transferring patients out of hospital remain stable, despite more than 60% of NHS finance directors reporting that delayed transfers of care have worsened over the last year. With other feedback also suggesting delayed transfers have got worse, the report calls for further investigation into this issue.