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ESTATES & FACILITIES
Driving service excellence with smart financing
Chris Wilkinson, head of sales for healthcare and public sector for SFS in the UK, examines how asset finance can help the NHS improve healthcare quality despite acute financial pressure in an increasingly competitive service landscape.
forcing acute trusts to be much more focused on service quality and efficiency, in order to assert themselves in a more competitive, patient-choice landscape.
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Now that transparent data on quality and safety achievements are being compulsorily published on the internet, the pressure has soared. The challenges to be overcome are enormous. The deadline of achieving £20bn of efficiency savings by 2015 is already looming.
Yet according to a survey by the King’s Fund in April, more than 80% of NHS finance directors believe that there is a ‘high’ or ‘very high’ risk of the NHS failing to achieve the efficiency target by that date.
The same survey also points out that only 40% of finance directors are confident that their organisations will balance the books in 2014- 15, with the figure plunging to a worrying 16% for 2015-16.
Intensified competition
Adding to financial efficiency pressures is intensified competition in a world where, with the introduction of the clinical commissioning groups (CCGs), patients are exercising choice about where they are treated. This means competition between acute trusts as well as between public and private sector health providers. With CCGs being responsible for commissioning acute and community care services for their local populations, the concept of ‘funds following the patient’ has now become a clear and present reality, presenting a major concern for acute trust planners and financial managers.
42 | national health executive Sep/Oct 14
he NHS is undergoing a sea change, with efficiency pressures and structural changes
Gone are the days where funds would be allocated to acute trusts based on predicted demand for services in their catchment area. Instead, choice and competition now set the rules for the new regime. Tasked with the remit to offer their patient community the best available health services, CCGs can now choose to commission only selected services from their local acute trusts and send their patients to other trusts where they are well-reputed to excel in a certain field.
Technological under-investment
In fact, it is not simply a matter of discretionary choice by GPs. The Health and Social Care Act 2012 requires CCGs to ensure good practice, to promote and protect patient choice, and to improve services for patients.
The consequences of failure
The new reform has consequences for acute trusts – those that fail to deliver quality healthcare will likely witness a drop in commissioning levels from CCGs, leading to falling demand in some areas, and undermining a trust’s ability to offer a full range of general hospital services at an affordable cost.
By the same token, acute trusts that are able to distinguish themselves with outstanding services will be able to attract patients and should see increasing demand.
In order to maintain a strong (and possibly growing) commissioning level from CCGs, the need for trusts to maintain standards of excellence despite the operating cost squeeze has become all the more critical.
“Extreme cost pressure has led to a backlog of technological under-investment in the NHS.”
The provision of superior service quality is intricately linked to the trust’s ability to offer the latest technological capabilities. Extreme cost pressure, however, has led to a backlog of technological under-investment in the NHS. According to the Association of Healthcare Technology Providers for Imaging, Radiotherapy & Care (AXrEM), the NHS cut back its investment in diagnostic imaging modalities between 2010 and 2012. The greatest decline has been in CT scanners, where the total
number sold decreased by 40%, followed by MRI scanners with a third (33%) fewer deals in the same period. Sales of digital x-ray rooms also saw a significant drop of 52% in 2012.
This under-investment comes at a time when the need for equipment upgrades is indeed more urgent than ever. A research study commissioned by Siemens Financial Services (SFS) reveals that healthcare organisations in the UK will have to invest close to £300m between 2013 and 2015 to replace diagnostic imaging equipment ‘in urgent need of replacement’ (defined by the relevant EU working group as over 10 years old). This urgency is further amplified by a 2011 report from the National Audit Office that revealed that more than half of the MRI, CT and linac machines in the NHS in England were due to be replaced by the end of 2014 at a cost of £460m.
Diagnostic imaging equipment used for prevention and therapy
With imaging being integral in most patient
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