HFMA evidence to the PAC’s inquiry into NHS financial management and sustainability

Emma Knowles

21 May 2020


Our key points are: 
  • the reasons for the financial difficulties that NHS bodies face are many and complex
  • there are indications that the financial position in 2019/20 may be better than in 2018/19, but there was still a reliance on on-off savings rather than systemic cost reduction and efficiencies
  • while capital to revenue transfers at the Department of Health and Social Care (DHSC) level will have had an impact on patient care, so would any alternative measure that would have had to be taken to ensure that the DHSC remained within its voted revenue resources
  • the changes made to the NHS financial regime by the DHSC and NHS England and NHS Improvement in response to the Covid-19 pandemic have been timely and agile. There is an opportunity to retain and build on the positive changes that have been made. Therefore, looking at financial arrangements in place prior to 2018/19 should only be done to allow lessons to be learned
  • work still needs to be done to understand and collect national data on the full costs of new ways of working
  • the NHS does not work in a silo, so changes made to the NHS financial management arrangements need to be mirrored by changes to the social care system 
  • as the nation recovers from the immediate impact of the Covid-19 pandemic, the role of NHS bodies as anchor organisations in their local economies should not be underestimated. 

HFMA evidence to the PAC’s inquiry into NHS financial management and sustainability

May 2020 (PDF 221KB)

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