Cuts in staffing and quality of care are “inevitable” if the NHS deficit is to reduce, King’s Fund analysis has found.
The report, Deficits in the NHS 2016, found that NHS providers and commissioners recorded a total deficit of £1.85 billion in 2015/16.
This is three times higher than the year before and the biggest deficit in NHS history despite financial controls and short-term measures to reduce cost.
The report found evidence that suggests the deficit is increasing pressures on general practice and community health services.
The number of community nurses has declined since 2009, particularly among the most senior district nurses, whose numbers fell by 30% with some community providers expressing concern about providing adequate staffing numbers.
“This is particularly worrying given the focus on increasing out-of-hospital care, which might have led us to expect a rapid growth in the community workforce over this period,” the report says.
The report says: “If restoring financial balance is the government’s highest priority, it is inevitable that staffing levels will need to be reduced.
“This presents a clear and present danger that patient safety and quality of care will be compromised and staff morale damaged further.”
The report argues that extent of the overspend shows that the deficit is not due to mismanagement in individual organisations but is, instead, a systemic problem.
To fix this, the report recommends the NHS improve productivity by improving clinical practice and reducing waste.
However, the researchers concede that this cannot be achieved at the pace or scale needed to meet the target of delivering £22 billion in efficiency saving by 2020/21.
The report adds that new models of care programmes will also not deliver major savings in the short term, even if they do offer opportunities to improve services for patients.
Helen McKenna, senior policy advisor at The King’s Fund, said: “Politicians need to be honest with the public about what the NHS can offer with the funding allocated to it.
“It is no longer credible to argue that the NHS can continue to meet increasing demand for services, deliver current standards of care and stay within its budget. This is widely understood within the NHS and now needs to be debated with the public.
“There are no easy choices, but it would be disastrous to adopt a mindset that fails to acknowledge the serious state of the NHS in England today.
“We are drawing attention to these issues now while there is still time to have an informed and honest debate about the best way of sustaining and transforming care.”