News, Policy & Media


NAO issues warning on long-term financial sustainability of the NHS

Yesterday the National Audit Office has published two reports: NHS financial management and sustainability and a Review of capital expenditure in the NHS.

  • The NHS financial management and sustainability report found that NHS provider trusts have a combined deficit of £827m, with clinical commission groups reporting a £150m deficit in the financial year ending 31 March 2019.
  • The NAO said that NHS trusts are becoming “increasingly reliant on short-term measures”, and patient waiting times were continuing to worsen. For example, the number of patients on waiting lists for non-urgent treatment has risen from 3.85m in 2017-18 to 4.23m in 2018-2019.
  •  The NAO also found that over the past five years, the government has transferred £4.3bn to revenue budgets to try and ease the pressures facing the NHS, but it is unclear how this has affected patient services. Instead, this extra money has “continued to drive volatility and variability among trusts”.
  • In conclusion, the NHS may struggle to deliver all of its commitments made in The NHS Long Term Plan. To ensure lasting stability, the NHS needs a financial restructuring programme.

Gareth Davies, Head of the NAO, said: “The short-term fixes that were introduced to manage the NHS’ finances are not sustainable. The Department of Health and Social Care continues to provide some trusts with short-term loans just to meet their day-to-day costs with little hope they will be repaid. This is not a sustainable way to run public bodies."

The NAO have made several recommendations, including:
•    The Department and NHSE&I should redesign the financial architecture to promote the behaviours needed to achieve the NHS Long Term Plan.
•    The Department should put a support system in place to provide assistance the most financially distressed organisations.
•    The Department and NHSE&I should develop a coherent long-term capital strategy to support the development of The NHS Long Term Plan


There is clearly a role for better use of IVDs in the health service to speed up testing, move patients along the pathway more quickly, and ensure they can be treated well in non-hospital settings, easing pressure on the NHS. BIVDA will be making this point to Ministers in our forthcoming Budget submission - members can contribute any ideas for this by getting in touch with Jon Harrison at 


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