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NHS achieves more for less
The NHS is treating more patients at lower cost, says a new briefing from the Audit Commission today (12 November).
The Commission's new briefing, 'More for less', suggests NHS trusts are increasing productivity and reducing unit costs, i.e. the average spent on each treatment. But overall, there is no sign yet that PCTs have been successful in moving care from hospitals closer to patients’ homes. This is one way to save more money.
'More for less' is an analytical briefing that looks at how NHS money has been spent, whether PCTs have been successful in keeping more patients out of hospital, and whether hospitals have become more efficient.
Andy McKeon, the Audit Commission's managing director of health, said:
'Productivity and quality are the twin foundations on which the NHS will face and weather pressures on public spending in the next few years. Hospitals are starting to become more efficient. But to reduce pressures and ease finances, the drive from primary care trusts towards providing equally good, if not better, care in the community needs to increase significantly.'
Among conclusions, the briefing finds that despite some contrary local evidence, national figures suggest PCTs made little or no inroad in 2008/09 in transferring care from hospitals to the community. The number of outpatients grew by 8 per cent and inpatients by 4 per cent.
Overall, the good news seems to be that NHS acute and specialist trusts are driving down unit costs. The latest figures show that, allowing for inflation, the 2007/08 costs were down by 3.7 per cent on the costs of two years before. This is partly helped by a significant increase in the number of less complex cases treated.
The briefing also comes up-to-date with a look at the first quarter of 2009/10. So far, the detail shows acute and specialist trusts have faced a 4.3 per cent increase in inpatient care paid for under the payment by results tariff (see notes). There may be further pressure on these trusts to reduce unit costs because income only rose by 2 per cent.
Notes for editors
- Primary care trusts are in charge of primary care and commission all secondary care (hospital) services. They also provide community services such as district nursing. They are now at the centre of the NHS and control 80 per cent of the NHS budget. They are local organisations and they oversee 29,000 GPs and 18,000 NHS dentists.
- Acute NHS trusts and mental health NHS trusts oversee 1,600 NHS hospitals and specialist care centres.
- Payment by Results (PbR) is a system of NHS payments that are made to acute and specialist trusts according to the costs of most individual treatments. For each treatment, sometimes known as spells, there is a nationally set payment. Specialised services are generally excluded from the tariff and payments are subject to local negotiation between the primary care trust and the NHS trust.
- The Audit Commission is an independent watchdog, driving economy, efficiency and effectiveness in local public services to deliver better outcomes for everyone.
- Our work across local government, health, housing, community safety and fire and rescue services means that we have a unique perspective. We promote value for money for taxpayers, auditing the £200 billion spent by 11,000 local public bodies.
- As a force for improvement, we work in partnership to assess local public services and make practical recommendations for promoting a better quality of life for local people.
- Further details about the role of the Audit Commission can be obtained from www.audit-commission.gov.uk
- Oneplace: since April 2009, the Comprehensive Area Assessment (CAA) is the mechanism for assessing locally-delivered public services, bringing together judgements from six inspectorates into one coordinated view of public services in an area. The primary focus is on the place (outcomes achieved for the community and assessing the risk to future improvement) rather than on organisations and their past performance. The inspectorates will publish an annual joint assessment for every area covered by a local area agreement on the CAA website. All the assessments will be at Oneplace on 10 December.
Nigel Watts, Media Relations Manager, Tel: 020 7166 2129 or 07813 315538