So....either Monitor did not work out the 'efficiency savings' aka cuts figure correctly in the first instance OR they put out a 'challenging' figure, Trust CEOs took the bait and agreed to go ahead without compromising front-line services (they must be having a giraffe) and now they find they are being asked over a 5-year period to cut 37% without compromising frontline services, patient care and safety.
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Hospital efficiency target rockets
By Sally Gainsbury and Nicholas Timmins
Published: April 28 2011 22:27 | Last updated: April 28 2011 22:27
NHS hospitals which took the government’s pledge to “protect frontline services” with “real terms” increases at face value, were hit by harsh reality on Thursday when their regulator said they would need to find efficiency savings equivalent to £2.9bn this year alone.
The 6.5 per cent savings target of the regulator Monitor for 2011-12 is 2.5 percentage points, or £1.1bn, higher than that set by the Department of Health in December.
Compounded over the five years for which Monitor has published projections, the efficiency target for hospitals is 37 per cent.
Chief economist at the King’s Fund think-tank, John Appleby, said the savings needed were a “substantial hike” over earlier forecasts.
“I can see a hospital doing this for one or two years but not five years,” Professor Appleby said. “It’s like the unit cost of a hip operation [around £6,000] has got to decrease by 37 per cent. How?”
The numbers are more than just a description of the financial pressures faced by the NHS, however. They are also the figures the regulator will use from May 1 to assess the robustness of applications from NHS hospitals to become independent foundation trusts and for any takeovers planned.
By, in effect, raising the bar for those assessments, Monitor may have made it more likely that struggling NHS organisations will be offered to private companies rather than merged with existing foundation trusts.
There are about 85 NHS hospitals and mental health trusts that have yet to become foundation trusts, with the government aiming to have all of them reach that status by April 2014. In the last financial year, when Monitor’s efficiency target was much lower at just 4.5 per cent, only seven organisations met its standards for approval.
The Department of Health is growing increasingly concerned about those hospitals within the 85 that have expensive private finance initiative deals which make foundation trust status unachievable. It has invited consultants to review 22 particularly severe cases and propose options.
The bulk of the gap between the health department’s 4 per cent efficiency target and Monitor’s 6.5 per cent is accounted for by changes in the inflation forecast and Monitor’s more pessimistic assessment of hospitals’ ability to cope with the new financial penalties that the department has introduced.
The consequences include not paying hospitals, in some cases, for patients who are readmitted. The health department assumes that hospitals will be able to reduce readmissions by 60 per cent over the next five years. However, Monitor assumes that readmissions will continue to grow at 4 per cent a year.
Monitor said: “It is a more challenging environment than in previous years. If Monitor had not made these adjustments, we would effectively have been lowering the bar and increasing the risk of failure among newly authorised foundation trusts.”
Nigel Edwards, acting chief executive of the NHS Confederation, said Monitor’s numbers “fit with the anecdotal evidence that we are hearing”.
He added: “Very few hospitals are having to make only 4 per cent efficiency savings. Many are facing six, seven or eight per cent and one or two over 10 per cent. And not necessarily for one year, but year on year for two or three years.
“Whether that is achievable without fundamental changes in the way services are delivered must be in doubt. “The history of this is not that encouraging and there must be questions about whether it is possible to deliver this.”
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| Topic | Date Posted | Posted By |
| Stop the Killing of Our Free Public Health Service | 11/04/11 12:16:00 | Eric Alan Leach |
| Re:Stop the Killing of Our Free Public Health Service | 13/04/11 08:49:00 | Arthur Breens |
| Re:Re:Stop the Killing of Our Free Public Health Service | 16/04/11 23:16:00 | Arthur Breens |
| Re:Re:Stop the Killing of Our Free Public Health Service | 16/04/11 23:17:00 | Arthur Breens |
| Re:Re:Re:Stop the Killing of Our Free Public Health Service | 19/04/11 11:50:00 | Eric Alan Leach |
| Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 10:05:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 10:31:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 10:58:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 11:13:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 11:38:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 12:00:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 12:09:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 12:08:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 12:23:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 13:33:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 13:59:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 20/04/11 14:14:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 21/04/11 09:45:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 21/04/11 15:00:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 21/04/11 17:27:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 21/04/11 17:49:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 23/04/11 21:50:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 24/04/11 10:15:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 24/04/11 12:55:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 24/04/11 10:13:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 24/04/11 20:32:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 25/04/11 09:20:00 | Ed Yelland |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 25/04/11 09:36:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 25/04/11 10:54:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 26/04/11 00:20:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Stop the Killing of Our Free Public Health Service | 01/05/11 10:00:00 | Eric Alan Leach |
| Monitor's new year-on-year cuts for Trusts | 01/05/11 10:44:00 | Allison Franklin |
| Re:Monitor's new year-on-year cuts for Trusts | 09/05/11 11:39:00 | Eric Alan Leach |
| Re:Re:Monitor's new year-on-year cuts for Trusts | 12/05/11 08:00:00 | Arthur Breens |
| Re:Re:Re:Monitor's new year-on-year cuts for Trusts | 12/05/11 23:49:00 | Arthur Breens |
| Re:Re:Re:Re:Monitor's new year-on-year cuts for Trusts | 17/05/11 09:45:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Monitor's new year-on-year cuts for Trusts | 18/05/11 19:34:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Monitor's new year-on-year cuts for Trusts | 19/05/11 23:42:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Monitor's new year-on-year cuts for Trusts | 29/05/11 11:54:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Re:Monitor's new year-on-year cuts for Trusts | 01/06/11 14:21:00 | Eric Alan Leach |
| Monitor's new year-on-year cuts for Trusts | 01/06/11 16:02:00 | George Knox |
| Private companies and the NHS | 03/06/11 19:51:00 | George Knox |
| Re:Private companies and the NHS | 04/06/11 11:01:00 | Peter Chadburn |
| Re:Re:Private companies and the NHS | 09/06/11 23:48:00 | Arthur Breens |
| Re:Private companies and the NHS | 10/06/11 09:45:00 | Ed Yelland |
| Re:Re:Private companies and the NHS | 10/06/11 11:01:00 | Eric Alan Leach |
| Council care homes less efficient -Yelland | 10/06/11 19:21:00 | Allison Franklin |
| Re:Council care homes less efficient -Yelland | 10/06/11 21:24:00 | Peter Chadburn |
| Southern Cross and the NHS in Ealing | 10/06/11 23:53:00 | Nigel Brooks |
| Re:Southern Cross and the NHS in Ealing | 11/06/11 11:25:00 | Peter Chadburn |
| Re:Re:Southern Cross and the NHS in Ealing | 13/06/11 09:37:00 | Eric Alan Leach |
| Re:Re:Re:Southern Cross and the NHS in Ealing | 15/06/11 07:28:00 | Eric Alan Leach |
| Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 18/06/11 12:08:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 18/06/11 15:30:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 09/07/11 15:38:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 18/07/11 19:50:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 22/07/11 08:06:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 01/08/11 12:30:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 05/08/11 08:35:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 26/08/11 23:23:00 | Arthur Breens |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 02/09/11 08:21:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 02/09/11 08:50:00 | Phil Taylor |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 02/09/11 08:58:00 | Peter Chadburn |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 02/09/11 09:23:00 | Eric Alan Leach |
| Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Re:Southern Cross and the NHS in Ealing | 02/09/11 09:59:00 | Tony Wood |
| 38degrees is a Social Democratic campaigning organisation | 02/09/11 10:17:00 | Phil Taylor |
| Re:38degrees is a Social Democratic campaigning organisation | 02/09/11 10:26:00 | Tony Wood |
| Re:Re:38degrees is a Social Democratic campaigning organisation | 02/09/11 10:52:00 | Tony Wood |
| Re:Re:Re:38degrees is a Social Democratic campaigning organisation | 02/09/11 11:35:00 | Phil Taylor |
| Re:Re:Re:Re:38degrees is a Social Democratic campaigning organisation | 02/09/11 12:08:00 | Tony Wood |
| Re:Re:Re:Re:Re:38degrees is a Social Democratic campaigning organisation | 02/09/11 14:27:00 | Eric Alan Leach |
| Polly Toynbee article on NHS Bill from Guardian 2.9.11 | 02/09/11 20:02:00 | Allison Franklin |
| Re:Re:Re:Re:Re:Re:38degrees is a Social Democratic campaigning organisation | 03/09/11 12:53:00 | Tony Wood |
| Re:Stop the Killing of Our Free Public Health Service | 02/09/11 22:12:00 | Peter Chadburn |
| Re:Re:Stop the Killing of Our Free Public Health Service | 03/09/11 09:57:00 | Arthur Breens |
| The Observer, 4.9.11 - Shirley Williams last attempt at getting our attention | 04/09/11 07:45:00 | Allison Franklin |
| Shirley Williams article, The Observer, 4.9.11 | 04/09/11 07:59:00 | Allison Franklin |
| Re:Shirley Williams article, The Observer, 4.9.11 | 06/09/11 22:52:00 | Eric Alan Leach |
| Re:Re:Shirley Williams article, The Observer, 4.9.11 | 06/09/11 23:03:00 | Peter Chadburn |
| Re:Re:Re:Shirley Williams article, The Observer, 4.9.11 | 07/09/11 12:16:00 | Eric Alan Leach |
| Re:Re:Re:Re:Shirley Williams article, The Observer, 4.9.11 | 25/10/11 15:28:00 | Eric Alan Leach |
| BMA have opposed every NHS reform | 25/10/11 19:30:00 | Phil Taylor |
| Re:BMA have opposed every NHS reform | 26/10/11 00:29:00 | Arthur Breens |
| Re:Re:BMA have opposed every NHS reform | 26/10/11 07:20:00 | Phil Taylor |
| Re:BMA have opposed every NHS reform | 26/10/11 00:31:00 | Eric Alan Leach |
| Re:Re:BMA have opposed every NHS reform | 26/10/11 08:00:00 | Allison Franklin |
| Re:Re:Re:BMA have opposed every NHS reform | 26/10/11 08:30:00 | Eric Alan Leach |
| Re:Re:Re:BMA have opposed every NHS reform | 26/10/11 12:47:00 | Phil Taylor |
| Jenny Tonge ashamed of the Lib Dems | 26/10/11 19:31:00 | Allison Franklin |
| Re:Jenny Tonge ashamed of the Lib Dems | 26/10/11 19:54:00 | Eric Alan Leach |
| Re:Re:Jenny Tonge ashamed of the Lib Dems | 27/10/11 08:12:00 | Arthur Breens |