NHS Improvement (NHSI) has released the quarter four (Q4) finance and operational performance figures for the provider sector. These figures cover the period 1 January to 31 March 2019. This briefing summarises the key headlines for those figures we as well our view of what they mean.

NHS Provider's view on the Q4 finance and performance figures

Responding to the year-end report on the performance of the provider sector, published by NHS England and NHS Improvement, the chief executive of NHS Providers, Chris Hopson said: 

“These figures show trusts are working flat out to ensure good quality care for patients in an extremely challenging environment, with demand rising to record levels.

“In that context what we see here is a strong financial performance.

“The overall provider sector deficit, at £571 million, was a significant improvement on last year’s figure, and £90 million better than previously forecast. “Once again, trusts have delivered impressive savings at 3.6% of turnover, alongside a further improvement in productivity.

“Yet the emphasis on quality was sustained.

“It was particularly heartening to see the proportion of trusts rated good or outstanding by the Care Quality Commission rising to nearly 60%, with the numbers up by 9% over the course of the year.

“And, despite enormous pressures, we have seen a big improvement in ambulance response times.

“There has also been good progress in reducing the longest delays, of 12 months or more, for routine surgery. NHS England said trusts should aim to reduce these by 50%. In fact they were down by 63%.

“However there is no getting away from the scale of the difficulties facing trusts, reflected in this report.

“It is clear that we are slipping further away from achieving the constitutional standards that patients rightly expect, and there is no realistic chance of recovering them without significant extra investment together with a clear plan setting out how this will be done.

“We also have to acknowledge that the push to improve the financial position is still far too reliant on one-off savings. These generated more than £1 billion in savings – far more than planned. This approach is not sustainable.

“Then there is the biggest challenge of all – workforce. We still have more than 96,000 vacancies, equivalent to 8% of the workforce which, on the current rate of improvement from the end of Q1 to the end of Q4 would take 7 years to fill.

“Finally, while we welcome this report’s focus on the significant widespread capital problems facing providers, it is clear to us that these difficulties have now reached a point of crisis, which must be addressed urgently. The fact that trusts have breached the capital allocation from government shows the importance they place on investing, where possible, to guarantee patient safety.

“Trusts are doing all they can, and have scored some significant wins for patients, in responding to growing demand. But across a range of issues, including finances, performance targets and workforce challenges, the provider sector is a long way off where we want and need to be.”