News review – December 2019

One piece of news directly related to the election was the announcement that Scotland will not see a 2020/21 Budget published until after Christmas. Finance secretary Derek Mackay said the postponement was unavoidable because the UK government Budget, scheduled for early November, had been cancelled due to the general election. The Budget for Scotland had been scheduled to take place on election day, 12 December, and a new date will be agreed as soon as possible, he added.

There is no doubt that there is a desire to improve diversity and inclusion in NHS finance – the challenge is to convert this into sustained actions, according to an HFMA and Future-Focused Finance briefing. As well as looking at the current diversity position in NHS finance, the document also explores practical steps that can be taken to make a difference.


Social care funding is a major issue in the election campaign, and the Institute for Fiscal Studies said local authorities will need an additional £4bn a year by the end of 2024/25 just to maintain current service levels. This assumes council tax rises at 2% a year. In a report, The outlook for councils’ funding: is austerity over?, the IFS said the funding would also ensure there are no further cutbacks in services. With 2% annual council tax rises, the amount needed would rise to an extra £18bn a year by the mid-2030s, it added.

The OECD said the UK has fewer doctors and nurses than many developed nations and, while access to healthcare is relatively good, it is less so for long-term care. In its annual review of health and care across developed nations, the OECD said the UK spends almost 10% of its GDP on health (public and private spending) – one percentage point higher than the OECD average. The level is expected to hit 11.4% by 2030.

Patients in Northern Ireland face an uncertain winter after Royal College of Nursing members voted overwhelmingly to take industrial action, which will include strikes, refusing non-nursing duties or non-participation in bank work on designated days. The union said nurses’ pay locally had fallen behind the rest of the NHS – by around 15% in real terms. Three dates have been set in December, where industrial action short of strike action will be taken. These will be followed by strikes later in December and the new year. NHS staff in Northern Ireland are unlikely to receive a pay award of more than 1% in 2019/20.

Health Education England will invest £18.5m in district nurse training in 2020/21. The funding will support community nurses who wish to study for the specialist practitioner qualification that allows them to become district nurses. Some of the money will be allocated to the district nurse apprenticeship programme in 2020/21. There will be further funds to support the development of district nursing.

The Welsh government and Northern Ireland Department of Health reached access agreements with the manufacturer of three cystic fibrosis drugs. One of the drugs, Kalydeco, is already available in Wales, but now patients there will also have access to Orkambi and Symkevi. A deal reached with NHS England last month stipulated that the manufacturer, Vertex, must offer the drugs on the same terms to health services in Wales and Northern Ireland.

Increasing the use of day cases for tonsillectomies could avoid costs of between £1.4m and £3.7m a year, according to a new Getting it right first time (GIRFT) report. The review of ear, nose and throat (ENT) services found that thousands more patients could be treated as day cases and overall it identifies potential cost efficiencies of between £21.7m and £30.8m a year.

Finance departments must embrace new technologies to give appropriate support to frontline changes, according to a briefing from the HFMA and cloud application provider Oracle. The document looks at examples of new enabling technologies, such as artificial intelligence and blockchain, and digital transformation in the NHS.