HEALTHCARE DELIVERY
one which is sustainable for the future.” According to the NHS Confederation, these conditions are not being met in full and this “threatens making a tough challenge impossible”. Most notable, it says, are the “decisions to cut spending on public health through the local authority grant” and delays to “much needed social care funding.” It warned that, while these cuts may deliver a short-term saving for the Treasury, there are strong indications this will come “at the expense of significant long-term costs and the possibility of hindering transformation.” In addition, the NHS Confederation has outlined four proposals to address concerns on delivering transformation and sustainability in the NHS. l HM Treasury should restate its commitment to transforming the health and care system, as described in the Five Year Forward View. This means establishing an explicit ring-fence for additional funding and creating arrangements to ensure it is spent on transformation, rather than ‘business as usual’ activities.
l The HM Treasury should enable investment in sustainability through spending on building and equipment. In particular, the NHS Confederation highlighted the fall in capital investment and the future impact of not investing in new technologies and buildings – the latter being “vital to supporting the delivery of new models of care”.
l HM Treasury should address the current state of social care urgently and bring funding into line with the NHS to sustain services. The NHS Confederation warned that cuts to social care funding are having a real and negative impact on the NHS. In the last five years, budget savings in adult social care budget have amounted
N WE PRODUCT
Stephen Dalton, chief executive of the NHS Confederation.
to around one-third, requiring reductions of £4.6 billion. Furthermore, tighter eligibility thresholds mean 400,000 fewer people now have access to state-funded adult social care. Unmet social care needs have increased demand on the NHS, including through longer and otherwise unnecessary hospital stays in the absence of adequate social care services.
l HM Treasury should recognise the flaw in making savings on public health and invest in keeping people healthy as a priority.
Phil McCarvill, deputy director of policy at the NHS Confederation, has previously highlighted funding as a serious concern, following the publication of the report ‘Social care for older people: Home truths’ by The King’s Fund and the Nuffield Trust. He described insufficient social care funding as “the most urgent threat to the NHS and the wider
health and care system.” The NHS Confederation has consistently called for an end to seeing the NHS, social care and public health as “three separate funding streams” instead viewing them as part of a single system.
“If we are to truly join up health and care then we need to support people to receive the care when and where they need it. Inadequate funding in one part of the system has a profound impact on the other parts to deliver the right care. Without this, local coordination and planning will become increasingly disjointed and the care individuals receive will suffer,” Phil McCarvill commented. In its latest statement to the Treasury, the NHS Confederation re-iterated that, if social care and public health funding are not fully protected, this will have a significant impact on the ability to deliver the Five Year Forward View.
CSJ
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