The economic regulator Monitor revealed on Wednesday that England’s flagship hospitals are under mounting pressure to balance their books as spending on the National Health Service remains flat.

It asserts that for Foundation Trusts (FT) to remain financially viable over the coming years, significant changes are likely to be required in the design of services and in what individual hospitals themselves provide. The current 137 FT hospitals previously had to prove they were financially robust in order to gain their status, but are currently “facing their most challenging period, with an increase in pressure across the sector”.

The number of those with the poorest financial risk ratings has risen this year to 11 in comparison with the previous year’s 4. From next year, an annual decline in income of 1% is predicted by FT’s as spending it cut, and commissioners attempt to distribute care out into other services and away from hospitals.

Monitor further asserted that a potential increase in financial risks may not be fully recognised yet, as 53 FT’s look to take over local community services from Primary Care Trusts. Furthermore, Monitor reported that the year-on-year efficiency savings FT’s say they intend to make are “ambitious”.

David Bennett, chair of Monitor said that FT’s have survived in the current climate so far by “paying attention to detail and concentrating on the basics”. He says however that with increasing financial pressures, this will not be sufficient to keep making the productivity gains needed. “They are going to have to start looking more fundamentally at what they do” he said.

While big changes to controversial areas of care such as maternity services and closures of accident and emergency services are less likely among the foundation trusts than among those still struggling to achieve that status, “they may need to make those sorts of changes in due course”, Mr Bennett said.

Whilst Monitor assert that current evidence from FT’s indicate that planned savings will not be recouped by treating fewer patients or reducing the level of care for patients, FT Leaders are anticipating the need radical service redesign, whether within their own organisations or across health economies.

Original Source Financial Times

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