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Report cover showing hospital with ambulances

Financial management in the NHS – NHS Summarised Accounts 2004-2005

‘There is no single cause of the deficits at NHS bodies and no single answer either. There are some systemic issues that have contributed to the deterioration in financial performance, but there are also local failings. The Commission is exploring this in more depth in two forthcoming reports – the review of the NHS financial management and accounting regime requested by the Secretary of State and Learning the Lessons from Financial Failure. Both of these reports will make recommendations to help put the NHS back onto a firmer financial footing.

‘One thing is clearer than ever: financial balance can only be achieved with commitment from finance staff, managers, clinicians and Board members. However the requirement for high quality, timely accounts must not be overlooked. There have been acknowledged weaknesses in the accounts of the NHS bodies and in 2004-05 there was evidence of inappropriate adjustments or omissions in more than a fifth of the accounts submitted for audit by NHS bodies. We have worked with NHS bodies, the Department of Health and NAO to address the weaknesses and hope to see an improvement in the quality of the 2005-06 accounts.’

Sir John Bourn, head of the NAO, said:

‘Many NHS bodies are managing their finances well, but it is worrying that a significant number are in deficit. All parts of the NHS and staff throughout the organisation must act together and take responsibility for improving financial management.

‘It is especially vital that financial control is not weakened as NHS bodies prepare for the impact of mergers and restructuring, as well as implementing Payment by Results and other national initiatives. It is also imperative that NHS bodies improve the quality of information underpinning both management and annual accounts. As well as supporting NHS Boards in informed decision-making, this will also allow local and national NHS accounts to be prepared, audited and published sooner.’

7 Jun 2006
Report cover showing stethoscope

Financial Management in the NHS: Report on the NHS Summarised Accounts 2007-08

“The surplus of £1.67 billion is equivalent to about one week’s funding for the whole NHS. The organisations in the NHS are performing better financially and this surplus has created an element of certainty for financial planning that has not existed in recent years. This is especially reassuring given current financial pressures throughout the economy.

“Auditors have found matters to be addressed, such as localised accounting issues, and there are long-standing financial problems affecting a minority of trusts. The significant challenges for the NHS next year are in meeting new International Financial Reporting Standards and tougher deadlines on closure of accounts, but it looks as though most NHS bodies are well placed to cope.”

Tim Burr, the head of the National Audit Office, said:

“Good financial management is not just about achieving a surplus. It is also about meeting delivery targets within the resources available. The surplus was generated through good financial management: NHS bodies delivered more cost savings than expected while still delivering against targets and improving the quality of healthcare. But better forecasting of the outcome could enable resources to be deployed more flexibly in-year.”

16 Dec 2008
Stethoscope on a chart

Funding healthcare: Making allocations to local areas

There is wide variation in the extent to which £79 billion in central funding allocated to local health bodies differs from target allocations that are based on relative need.

• This is NAO’s first report on funding since the 2013 health reforms took effect. Where possible comparisons have been made with funding under the previous system set out in a 2011 NAO report.

11 Sep 2014
Report cover showing surgeons operating on a patient

Handling Clinical Negligence Claims in England

“The human and financial costs of clinical negligence are enormous. At the end of March 2000, some 23,000 claims for clinical negligence were outstanding. The net present value of known and anticipated claims at that date was £3.9 billion. Many claims have been outstanding for a long time, and the present system is a slow and inefficient way of resolving small and many medium size claims.

“The Litigation Authority and the Legal Services Commission are making improvements to the way they handle claims. Implementation of our recommendations should provide patients with improved access to remedies, speed up settlements and cut legal costs.”

3 May 2001