At face value you have to applaud any organisation that turns a significant deficit into a £510 million surplus in the last financial year. This was achieved against a background of mismanagement with over 68 Trusts still operating at a deficit at the end of the financial year. Foundation Trusts who receive their budgets separately have performed well with a budget surplus of over £130million. So how did the NHS do this and what is the long term impact of this new management style?

There are endless well documented press reports leaked from loyal NHS employees highlighting the fact that training budgets have been raided, vacancies frozen and redundancies now a part of every day life. The impact on nurses alone has been devastating with established nurses losing their jobs and newly qualified nurses unable to find jobs, this combined with the closure of wards and perceived “non essential services has seen morale hit rock bottom. The NHS in its haste to achieve a surplus may have axed unnecessary jobs putting enormous pressure on an already overworked workforce. A financial slight of hand may have been used by the NHS to ensure that the books were balanced.

The practice of raiding successful Trusts (Top Slicing) budgets to use their surpluses to prop up failing Trusts is common place. These funds were returned back to the PCTs but not before the Trusts involved were forced to make cuts to save money which could have been unnecessary. In many cases these cuts would have filtered through as cancelled operations due to the lack of funding available as well as the limitations imposed on prescribing certain drugs. PCTs have also found that the funding formula that governs how much they receive per operation has failed to cover the costs. This has resulted in even well run Trusts failing to cover costs

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