Pressures on hospital service provision

A key element of ensuring robust financial planning in the medium and long term is to shift the focus to prevention rather than cure. The PCT needs to ensure that it spends its limited resources in those areas which demonstrate the best outcomes to ensure maximum value for money. Again there is a clear synergy with the PCT’s focus on health improvement and reducing inequalities. Value for money is therefore defined in terms of economy, efficiency and effectiveness.

A key financial risk is the acute activity growth which has often exceeded the growth in resources. This has been exacerbated by the need to invest in the achievement of the 18 weeks target, the additional activity that has been seen due to higher referrals that are the consequence of the reduction in waiting times, and the increasing expectations of the population.

Current hospital activity shows that patients being admitted to hospital could and should be cared for in their own home or in more accessible community settings. In particular, people with long-term ill health are frequent attendees at hospital accident and emergency departments and often have several hospital admissions every year. Compelling evidence suggests that many of these attendances could be avoided if people were proactively supported and treated by community services

There have been changes to working time directives for doctors. In order to maintain current service levels Barnet and Chase Farm hospitals will need to recruit an unrealistic number of doctors. Furthermore, hospital services have been identified as being under threat as a result of new regulations such as Accident and emergency and women and children’s services ie. maternity and paediatrics

It is true to say that hospital treatment is becoming increasingly specialised and there is overwhelming evidence that patients with the most serious illnesses are best treated in specialist centres.