Effects of the NHS reforms on financial sustainability

Abstract

The Health and Social Care Act of 2012 (HSCA2012) has transformed the operational and business environment within which NHS trusts in England operate. The Shelford Group is the leading multi-specialty NHS trusts in England. The aim of this study was to assess the impact of HSCA2012 on the financial position of the Shelford Group of NHS trusts. The annual account statements produced by each of the trusts for financial years (FY) 2011–12; 2012–13; 2013–14 and 2014–15 were reviewed and the key financial indicators (KFIs) for each organisation were collected. KFIs for the period just prior to enactment of HSCA2012 (FY2011–12, FY2012–13) were compared with the corresponding values for the period after the enactment of HSCA2012. The clinical services provided by the Shelford Group increased year on year by 10.6%, 7.5% and 4% respectively as did their combined annual income. In FY2014–15, the Shelford Group collectively provided 14 735 000 patient care episodes and reported a combined annual income of £9 672 066 000. There was no significant difference in the median operating surplus returned by the Shelford Group before and after HSCA2012; despite this, 5 of the 10 Shelford Group members delivered an operational deficit in FY 2014–15. The level of financial liabilities and total capital employed remained stable. There were significant improvements in total assets employed in the Shelford Group in the 2 years after the enactment of HSCA2012 compared to before. The financial standing of Shelford Group trusts has not been adversely affected by the enactment of HSCA2012, although there was some evidence that the operational finances of these NHS trusts were less robust in FY 2014–15 than previous years.