More medicine needed: the health of health finances revisited

Much has happened, but has anything really changed since CIPFA published The Health of Health Finances in 2015? 

In that briefing we concluded that the health system was not sustainable under existing plans, and by the time of the Comprehensive Spending Review in October 2015, CIPFA’s assessment had become something of a consensus. There was comparable analysis emerging from the King’s Fund, Health Foundation and Nuffield Trust. The government’s recognition of the issues faced by the NHS, and the actions set out in the Comprehensive Spending Review and subsequent guidance, are encouraging. 

However, CIPFA feels the financial model behind the Five Year Forward View is not tenable and creates both financial and leadership challenges for everyone in the NHS. It’s not simply a case of saying that more money is needed. It may be in the short-term that a more permissive approach to rationing and prioritisation is an alternative, and there are various longer-term options. 

What is vital is that the position is addressed in the right way both in the short-term and as part of the realistic long-term planning which should form the core of the government’s thinking.