NHS Financial Year 2010/11: A summary of auditors' work
NHS Financial Year 2010/11: A summary of auditors' work, provides a view of the overall financial performance of the NHS in 2010/11 and summarises the audit of the 2010/11 accounts for strategic health authorities (SHAs), NHS trusts and primary care trusts (PCTs).
It also looks at auditors' conclusion on the value for money (VFM) arrangements in place in each organisation and reviews the progress made by PCTs and NHS trusts in delivering their cost improvement programmes.
We found that the overall financial performance of most health bodies was good and:
- NHS organisations delivered a surplus of £1.5 billion and total efficiency savings of £4.3 billion;
- only 9 organisations out of 276 failed to balance their books;
- some NHS organisations required financial assistance to balance their books;
- almost a quarter of NHS trusts (27) and 12 per cent of PCTs (18) received qualified VFM conclusions; and
- all PCTs, NHS trusts and SHAs submitted their draft accounts to the Department Health and auditors on time, and there were no qualified true and fair opinions.
Improving coding, costing and commissioning: Annual report on the Payment by Results data assurance programme 2010/11
Our Improving coding, costing and commissioning: Annual report on the Payment by Results data assurance programme 2010/11, was published on 22 September.
We said that the data used to inform the current Payment by Results (PbR) tariff in the last financial year was generally good, but the NHS needs to improve the quality of its data if the government is to expand its PbR system.
The data for 'non-tariff' areas such as community services and chemotherapy was often of poor quality, and it is these areas that will be brought under the PbR umbrella under the government's plans. This data is also currently used to inform local contracts.
There is a checklist of 10 basic steps that each trust should ensure it takes in order to improve the quality of its reference costs submissions. The checklist and details of each trust's performance are available on our website.
The new benchmarking report from the PbR data assurance framework
The new PbR data assurance framework report is aimed at busy senior staff and is designed to be easy-to-digest. NHS staff are able to find further analysis online in our National Benchmarker online tool, which is freely available to the NHS.
This report utilises our newly released volume analysis, which uses a PCT's standardised population to determine an expected level of hospital activity for the PCT. From this we can identify exceptionally high or low volumes of activity, and estimate the financial impact of this.
This report provides analysis that can help commissioners in discussions with local providers around contracting and commissioning issues. The benchmarking report was launched in July to help provide information that could be used during the second stage of our commissioner arrangements review to be undertaken at PCTs this autumn.
If you would like to talk to us further or to provide any feedback, please email pbr-benchmarking@audit-commission.gov.uk
Coming later this year
Joining up health and social care: Improving value for money across the interface
Later this year we will publish a report looking at the interface between health and social care.
In it, we will examine partnerships and the data that needs to be shared and reviewed between the NHS and local government to ensure older people receive the right care, at the right price to the taxpayer.
At a time when the whole of the public sector must find significant savings, integrated working across health and social care offers opportunities for efficiencies and improvements to services. Without it, there is a risk of wasted effort and 'cost-shunting' where savings made by one organisation or sector create costs for others.
The briefing will set out:
- potential areas for local action;
- the questions which local commissioners might ask themselves and the evidence that may help with the answers;
- potential indicators for identifying areas for improvement and for tracking progress; and
- what the national data suggests in these key areas.
Looking at data definitions
The Audit Commission, Department of Health, NHS Information Centre for Health and Social Care and NHS Connecting for Health are working together to resolve some of the problems about how data are defined under PbR which often lead to disputes.
We are reviewing the guidance for:
- ordinary admission;
- day case admission;
- regular day and night attenders;
- outpatient first/follow-up;
- ward attenders; and
- the way diagnostic tests and procedures are recorded in these settings.
We aim to publish a briefing later this year providing clear guidance and recommendations