Monitor release NHS Foundation Trusts quarterly performance review

For the first time, NHSFTs ended the year with a net deficit of £349 million and an aggregate earnings before interest, tax, depreciation and amortisation (EBITDA) margin of 3.8 per cent.
 
The NHSFT sector has consistently failed to meet the 95 per cent accident and emergency (A&E) four-hour waiting time target during 2014/15. In Q4 2014/15, NHSFTs treated or admitted 91.6 per cent of A&E patients within four hours, the lowest ever quarterly performance delivered by the sector.

In Q4 2014/15, 55,400 patients waited for a bed on a trolley for more than four hours, an increase of 114 per cent compared to the year before. Although this, to some extent, reflected NHSFTs’ failure to manage their patient flows and working with other providers, issues with social care provision has become a barrier to NHSFTs effectively discharging patients.

The average waiting times for admitted and non-admitted pathways were 8.9 and 5.2 weeks respectively, similar to last quarter. However, the number of patients waiting longer than 18 weeks has risen to 128,000. This was 31 per cent higher than March 2014, highlighting a risk to achieving the targets in the coming year.

NHSFT have indicated to Monitor that 2015/16 is likely to be even tougher. If the sector continues to operate on a business as usual basis without any funding injections or delivering substantial efficiency gains, the trajectory for 2015/16 and beyond is likely to deteriorate rapidly.

Significant activity pressures and a need to deliver operational standards meant that the planned improvement quarter on quarter did not transpire due to increased staff costs. Instead, the sector’s cumulative financial performance deteriorated each quarter during the year.

Paul Briddock, Director of Policy, Healthcare Financial Management Association (HFMA), said: “The latest Monitor Quarter 4 performance report for Foundation Trusts demonstrates further distressing news on how the sector is performing. As the new Government settles in, the demand on healthcare services continues to increase against a backdrop of ambitious efficiency targets and quality initiatives.

"The financial pressures are mounting as we continue to see foundation trusts report a shortfall of £349 million, with 51 per cent of all FT’s and 70 per cent of acute FT’s now being in deficit. Overall the sector reports an catastrophic deficit of £822 million.”

Rob Webster, chief executive of the NHS Confederation, said: “This report provides a clear indication of the pressures faced by the NHS today, with the Foundation Trust (FT) sector posting a year-end deficit for the first time. The financial issues within providers are well-documented and these figures further highlight the impact from an FT perspective.

"Sustainability in the NHS is a challenge that must be met by the whole system and we will need to see strong leadership over the next five years to meet it.”

Read the report