Trusts are being fined by their clinical commissioning groups for missing patient waiting targets. Some will see this as counterproductive as the very reason for missing such targets is often owing to a shortage of available funds to achieve their goals.
The fines levied on hospital trusts total £600m, some 90% of which are expected to be in deficit when the financial year closes on 31 March 2016. The fines relate to failing to treat A & E, cancer and non-urgent care patients quickly enough. The largest NHS Trust, Bart’s in London, was fined a total of £53m last year; it’s total deficit ran at £79.6m and had the fine not been levied it would have seen the Trust running only marginally over budget.
There are other occasions where such fines have led to Trusts that were otherwise set to break even instead posting a deficit. Historically CCGs waived fines if they thought Trusts had a sufficiently good reason for missing their targets; however from April 2015 it became compulsory to impose the fines.
NHS England has stated that such fines provide the incentives for Trusts to meet their targets and reduce waiting times for patients; and in another U-turn it has announced that it will not be imposing the fines next year to support Trusts balance their budgets.
Quite whether these fines have historically provided the impetus to tackle waiting times for patients is up for debate; surely imposing financial penalties for missing performance targets in a time of increasing financial pressures on NHS budgets is not the soundest economic policy.