At least three trusts have efficiency targets approaching 10 per cent of their budget this year, HSJ research has found.
Blackpool Teaching Hospitals, South Central Ambulance and Queen Elizabeth Hospital King’s Lynn foundation trusts were among those with cost efficiency programmes close to 10 per cent for 2024-25 — around double the average figure provided by responding trusts.
The research, based on Freedom of Information Act responses from 150 of the 215 English providers, also found that seven of the 10 trusts with the biggest savings targets had fallen behind their plans.
HSJ asked every trust for their Cost Improvement Programme in value and as a share of expenditure. The trusts with the highest planned savings were generally district general hospitals, community and mental health trusts. In contrast to the trusts above, the largest providers are planning much lower efficiency rates, averaging at less than 5 per cent (details in second chart below).
The average CIP of the trusts that responded was around 5 per cent of turnover. But the actual average figure across all trusts could be even higher, with one source putting it at closer to 6.5 per cent. In some cases, the trusts’ savings targets have been increased since the start of the year.
South Central Ambulance Service’s CIP target of 9.6 per cent followed in-year “adjustments”, which it said it was on track to hit, while Blackpool Teaching Hospitals said in board papers its CIP was around 10 per cent of expenditure. Most of the 10 providers with the biggest CIPs as a proportion of expenditure have fallen behind their savings plans, according to statements from the trusts or their most recent public board papers.
This group includes Queen Elizabeth Hospital King’s Lynn, which said there was still a “significant gap” between the plans and actual schemes in place, while Royal Wolverhampton told HSJ the trust “does not have identified plans for all of its CIP.”
It comes as one of the service’s leading finance professionals said his colleagues were being pushed to present “unrealistic” CIPs to produce financial plans that were acceptable to NHSE.
Hardev Virdee, chief finance officer at Barts Health Trust, said he was increasingly seeing “cracks appearing in some senior finance professionals who are struggling to really cope with the level of pressure”. This year, trusts and integrated care boards are collectively aiming to deliver efficiency savings of 6.7 per cent, or more than £9bn, the highest level in recent years.
A third of this is to be achieved through one-off savings. Since the pandemic the service has delivered around 5 per cent in efficiencies each year. CIPs include measures to cut spending, such as reducing numbers of agency rates and the rates paid, as well as wider productivity improvements, such as bringing down length of stay and boosting theatre usage.
The 10 trusts with the highest CIPs were asked whether they were on track to meet their goals and what measures were in place to ensure patient safety was protected. A spokeswoman for QEHKL said the trust had been able to reduce bank and agency usage following successful recruitment and had been able to use its inpatient beds more efficiently by speeding up discharge processes. They said patient safety “remains our top priority”.
A spokesperson for The Royal Wolverhampton Trust said it applies quality impact assessments to proposals and “any with a negative impact on patient care do not proceed”.
Isle of Wight Trust said all improvement schemes were subject to a formal review process.
Source: HSJ
Date: 6 November