Jason Parker, Head of Health at KPMG, comments on what he would like to see from next week’s Budget
Jason Parker, Head of Health at KPMG, comments on what he would like to see from next week’s Budget.
He says: “I hope that next week’s Budget reflects the fact that it will be one of the most critical announcements for the NHS in several decades.
“The budget announcements can skirt around any mentions of the NHS because in monetary terms, the NHS is receiving more money each year. But when you take into account inflation, increasing demand, staffing pressures, and increased cost of supplies, then the cash injection is falling well-short of the mark.
“I expect the budget to have a particular focus on community care – which is the right approach for reducing pressure on the system in the long-term – but it shouldn’t be at the expense of our hospitals. The positive impact from investment in community care will take a long time to show its effects, and so the Budget should recognise that investment in acute trusts in the short-term is essential. This is particularly important as we approach winter, when demand and pressures on hospitals are at their highest.
“The obvious concerns around staffing need attention, and I hope that the Government will allocate funds to develop the ‘right workforce for tomorrow’. It is critical that the NHS invests time and money in considering the specialisms we will need in the future. With a shift away from care in the hospital setting to community care, the NHS will be more sustainable if it trains up more doctors and nurses to be ‘generalists’, and fewer as specialists. In the US for example, ‘hospitalists’ care for a wide variety of people in hospitals and plug gaps where there’s poor staffing.
Service and capital transformation
“Particularly important for the sustainability of the NHS, is budget to enable service transformation. Whole systems are constantly being asked to transform and make efficiencies, but this simply isn’t possible without pump-priming in some way.
“Part of that pump-priming needs to be about capital transformation. Surplus estate can help trusts fund investments – but margins on NHS services are now so thin that they will rarely pay back an investment in new estate. In other words, unsustainable systems need new estate to deliver quality care and to implement their sustainability plans – but they are unable to make the business case to allow for this. It’s a Catch 22 that needs to be addressed with a targeted programme of renewal, especially for community estate.
Accountable care systems
“The Spring Budget showed a commitment to taking ‘Sustainability and Transformation Plans’ to the next step. Vital for focusing resources on the actual needs of the local population – rather than having a one-size-fits all approach – STPs have made progress. Accountable Care Systems (ACS), which is an evolved version of an STP covering part of the STP’s geography, are the next focus. I hope that Phillip Hammond’s Budget next week takes into account that a cash injection here will save the system millions in the long-run.”
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Notes to Editors:
KPMG LLP, a UK limited liability partnership, operates from 22 offices across the UK with approximately 13,500 partners and staff. The UK firm recorded a revenue of £2.07 billion in the year ended 30 September 2016. KPMG is a global network of professional firms providing Audit, Tax, and Advisory services. It operates in 152 countries and has 189,000 professionals working in member firms around the world. The independent member firms of the KPMG network are affiliated with KPMG International Cooperative ("KPMG International"), a Swiss entity. Each KPMG firm is a legally distinct and separate entity and describes itself as such.