Foundation hospitals plan to take on more frontline staff

24 Jul 2013 02:44 PM

NHS Foundation Trusts (FTs) have reported to Monitor they intend to recruit 10,000 more clinical staff to raise the quality of care.

The sector regulator's annual review of FT plans shows trusts are forecasting to take on 1,134 permanent consultants, 1,273 junior doctors and 4,133 nurses and midwives in 2013/14. They will also be increasing the amount of health care assistants, ambulance paramedics, social care and theatre staff.

This follows an unprecedented number of trusts failing to meet national targets to ensure that patients wait less than four hours in A&E. The sector forecasts improved compliance with the A&E target in 2013/14 as a result of the investment.

This investment will cost an estimated extra £500m (or 2% of current staffing costs) and is also intended to maintain staffing levels following the failures of care highlighted by the Francis and Keogh reports.

Dr David Bennett, Chief Executive of Monitor, said:

"We are pleased the sector is investing some of its surplus in increasing resources to improve patient care and hope this will relieve some of the operational pressure the NHS is currently facing."

At the end of 2012/13 the sector had accumulated £4.5bn in cash and the report shows that trusts plan to invest almost £1bn of it this year. Total planned capital expenditure of £2.6bn is 50% higher than the actual spend in 2012/13 as the sector looks to build capacity, undertake strategic development and invest in improving and modernising the estate.

On the basis of the track record of FTs in recent years, the regulator’s Annual Plan Review indicates the sector will continue to be resilient in the short term, although some individual trusts will struggle.

However, the review shows that on-going efficiencies are becoming harder to deliver as one-off savings such as cuts in management costs start to slow. Last year savings were 21% lower than planned and trusts are revising down their future expectations accordingly.

Stephen Hay, Managing Director of Provider Regulation at Monitor, said:

"In the short term, the sector’s balance sheet is in reasonably good shape overall, but we know that the number of FTs in financial distress has increased, as has the number struggling to meet operational demands.

"However, the outlook on overall funding is uncertain and the spending review has confirmed that financial pressures will increase beyond 2015/16. Our review now suggests the balance of longer term risks has shifted to the downside."

Stephen Hay added:

"The sector has a good track record of forecasting its performance in the first year of its annual plans, but its projections for years two and three appear optimistic. In view of this risk, Monitor will enhance its scrutiny of high risk areas to enable us to take early action if necessary.

"Given that traditional cost saving opportunities appear increasingly to be depleted, one way of addressing financial pressures in the medium term is to deliver more fundamental change.

"There are significant opportunities to drive productivity and improvements for example through innovation; and unless FTs start to deliver this fundamental change now there is no guarantee the sector will be as resilient in the future."


  1. For media enquiries contact Nick Burke, 0207 340 2443 or (Nicholas.burke@monitor.gov.uk)
  2. Monitor has reviewed the annual plans of the 145 NHS foundation trusts authorised prior to 31 April 2013, of which 19 are in special measures because they are in breach of their licences
  3. The report based on the 2013/14 Annual Plans (written plans, financial returns and governance returns) is being presented to Monitor’s Board on Wednesday 24 July 2013 and is available here
  4. Monitor requires foundation trusts to produce realistic plans (based on discussions with their commissioners) to help them identify any potential issues and make sure patients’ needs are met. The plans consist of a financial forecast for the next three years and a one year assessment of governance risk, which reflects the overall effectiveness of an NHS foundation trust’s leadership
  5. Monitor is the sector regulator of NHS-funded health care services. Under the Health and Social Care Act 2012 its main duty is to protect and promote the interests of people who use health care services. Information about Monitor's new role can be found here
  6. Follow on Twitter - follow us @MonitorUpdate