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Friday 28th October 2016

Action plan for busting NHS deficits by 2011

25th October 2010

Writing in HSJ, Nick Bosanquet, professor of health policy at Imperial College, London, outlines an action plan for tackling NHS deficits.


NHS trusts are facing a drastic shift from a past of overtrading and annual cash increases of 10% to a future in which cash incomes will fall by 2% or more.

And the nature of the operating framework looks set to shift deficits from primary care trusts to hospital trusts.

Some are already facing severe problems and the challenge is to avoid a scenario where NHS organisations run out of cash.

This needs to be managed with a financial crisis expected to emerge around 1 November 2011. For many trusts, the outlook will be dire.

Once the scale of the problem has been identified, trusts will have to estimate their costs and develop action plans to live within their budgets. Those need to be in place by 1 January to avoid an "insolvency crunch".

After any crisis is averted, a new financial framework for commissioning can be developed but within the NHS a side effect of this crisis could be a complete block on innovation.

There is however, still time to avoid the looming NHS financial crisis of 2011 but a clear action plan is needed.

Key elements to this would be retaining PCTs, though renamed, as the development agencies for the GP consortia; put GPs on PCT boards; develop commissioning templates so that the new GP consortia can build on the success of the national service frameworks; set up GP led task forces on budget, finance and outcome measures and develop partnerships with private and voluntary enterprise to lower costs.


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Tuesday 9th November 2010 @ 17:00

I am surprised that Nick Bosanquet believes that the financial crisis experienced by NHS hospitals will create a block for innovation. Surely it is possible that this financial pressure will require the NHS to review its ‘business as normal’ practices which have previously been accepted as the status quo and subsequently drive change through the organisation? In this context could innovation be an instrument for success in the challenging economic environment? Bringing process and cost savings to the NHS which it so desperately needs.

I would be interested to hear the views of others on this issue.

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