The NHS in England in 2013

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.e8634 (Published 02 January 2013) Cite this as: BMJ 2013;346:e8634
  1. Chris Ham, chief executive
  1. 1King’s Fund, London W1G 0AN, UK
  1. c.ham{at}kingsfund.org.uk

Funding and service pressures are likely to have an impact on the quality of care

The end of 2012 saw the NHS in England facing increasing demands from patients as a result of winter pressures and the norovirus. These demands have been compounded by cuts in social care funding and support, which make it difficult to prevent hospital admissions and ensure timely discharge. Despite these pressures, the performance of the NHS is holding up well on most of the available indicators, although a growing number of providers are in deficit, and it is proving difficult to maintain short waiting times in emergency departments.1

What then are the prospects for the NHS in 2013? As it enters the third year in which its budget will grow only in line with inflation, financial and service pressures on England’s NHS seem certain to increase. A recent survey of finance directors found that, on the basis of their plans and those of other providers in their area, many thought that quality of patient care might be adversely affected in 2013.2

Providers may also find it difficult to balance their budgets when, as the National Audit Office reported recently, most of the “easy” efficiency savings have been achieved.3 The irony here is that prudent financial management over the past two years has …

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