The real reason for the huge NHS overspend?

Abstract

40 British Journal of Healthcare Management 2016 Vol 22 No 1 © 2 01 6 M A H ea lth ca re L td behaviour is effectively removed and small number monthly variation is minimised. The periods of high unexplained death shows up in a running 12-month total as an inverted ‘V’, where the upward slope represents a step-like increase in deaths lasting for somewhere around 12 months, and the downward slope simply shows the dilution of the running total after cessation of the step-change. The magnitude of the step-change is shown by the difference from trough to peak and, as can be seen in Figure 1 can be very large or even seemingly absent on some occasions. Differences in timing between local government areas can be discerned, and these differences arise from very small area spatial spread of an as yet unidentified agent (Jones, 2015c-f). Increased medical admissions and bed occupancy mirrors the increase in deaths (Jones, 2015b; 2015h–i; 2016). Figure 1 illustrates the principle that something strange—probably infectious–is happening, which affects levels of medical admission and costs. Also note that the funding formula does not contain any correcting factors to account for this behaviour (Jones, 2013). Table 1 quantifies the magnitude of these step-like increases in death for a variety of the largest regions (in italics) and counties during a number of these suspected infectious outbreaks. Both maximum step-up and step-down are shown in the last two columns simply because the value of the step-down gives an alternative measure for the strength of each event. Immediately apparent is a wide range in percentage increases between regions for each event, with the 2004 (and to a lesser extent 2002) event being below the limit of detection (n/a) in a range of locations. Generally speaking, the 2012 and 2014 events are the highest in magnitude, with 60% of all local government areas in England and Wales having the greatest magnitude of increase in deaths (and hence medical admissions) in 2014, and as such will have the greatest impact upon NHS financial pressures. However, the principle observation is that different locations will experience different cost pressures, such as Essex (+5.4%) in the 2010 event versus +0.6% in Rod Jones The real reason for the huge NHS overspend?