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Half of health commissioners say quality has worsened in the last year

Nearly half of finance experts at clinical commissioning groups (CCGs) said that quality has declined in their area in the last year, according to the Quarterly Monitoring Report released by The King's Fund.

The poll that the report analyses found that 48% of CCG finance leads, and for the first time more than half of directors (53%), believed that quality of care has worsened in their area.

It also revealed that NHS trusts are forecasting an end-of-year deficit of around £2.3 billion, based on the responses from 83 trusts.

Commenting on the report, John Appleby, chief economist at The King's Fund, said: “Even with the additional funding recently provided by the Treasury and a big switch from capital to revenue spending, it is touch and go whether the Department of Health will be able to balance its budget at the end of the year.

“At the same time, performance is deteriorating with key targets being missed with increasing regularity and increasing concerns being raised about the quality of patient care. This is shaping up to be a make or break year for the NHS.”

The data analysis included in the report from the survey found that 8.2% of patients are still waiting for a planned hospital admission after 18 weeks in December - the first time the target has been missed since it was introduced in April 2012.

Cancer waiting times have improved, with 16.5% of patients waiting more than 62 days for treatment following an urgent referral from their GP. However, this is the eighth consecutive quarter this target has been missed. 

The number of delayed transfers of care remained high, with more than 5,000 patients awaiting discharge from hospital at the end of December - the highest number for this time of year since 2007.

In terms of A&E waiting times, 9% of patients waited longer than four hours in A&E over the quarter up to the end of December 2015 - the worst quarterly performance since 2003.

The total waiting list for planned hospital admissions in December was estimated at 3.5 million patients - equivalent to the populations of Greater Manchester, Bristol and Southampton combined.

Other key findings include:

·       More than two thirds of trusts (67%) and nine out-of-10 (89%) acute hospitals are forecasting a deficit at the end of 2015/16.

·       More than half of trusts (53%) are concerned that they will not be able to meet nationally-imposed caps on their agency staff spending, while a fifth (22%) say the caps may impact on their ability to recruit the staff they need to provide safe care.

·       Nearly two-thirds (64%) of trusts are reliant on extra financial support from the Department of Health or drawing down their reserves.

·       More than half of trust finance directors (53%) are concerned about meeting productivity targets - the highest level of concern at this time of year since our survey began.

·       CCGs are in a better financial position, although nearly one-fifth (18%) are forecasting a deficit and nearly a third (29%) are concerned about meeting their productivity targets.