A National Audit Office (NAO) report shows that NHS England is spending more on specialised services compared to other areas. While the NHS took this initiative three years ago, it does not have consistent information from all NHS contractors on costs, access to service, outcomes of the services, and how efficiently the services are being delivered. The NHS still doesn’t have an agreed service strategy with the medical contractors.
Patients with rare conditions receive specialised services, and those who require a specialised team at a centre can avail these services. Presently, the UK has 146 specialised services that cover a range of conditions, such as rare cancers, renal problems and specific mental health conditions.
Between 2013 and 2015, the NHS budget for specialised services has witnessed an increase from £13 billion to £14.6 billion. This represents an average 6.3 per cent increase annually. The entire NHS budget has increased 3.5 per cent a year. NHS England has been unable to stay within the budget allocated to these services, and is aware that even in future, it would be difficult to keep within budget, even though it has increased the 2016-17 budget by 7 per cent.
If the NHS continues exceeding the budget for specialised services, it will affect other healthcare services, such as primary care, community services and non-specialised hospital services.
The NAO has highlighted several factors that are putting financial pressure on NHS specialised services. These include the increasing volumes of expensive new drugs, and rising demand for specialised services.
NHS England and NHS Monitor have been working together to control the spiralling costs. They have reduced the price paid to NHS contractors, but this has had financial repercussions on the service providers. While the NAO has found that offering contracts on a national level has worked to the NHS’ advantage, as it can influence the contractors and reduce prices, there is the question of the commissioning centres’ ability to manage contracts effectively.