Trusts accused of ‘gaming’ £2bn elective fund

Government has ordered a review into how the NHS is spending billions of pounds of extra elective recovery funding, over concerns trusts are charging more for procedures but not treating significantly more patients, HSJ has learned.

NHS England is understood to be carrying out the urgent review, looking at a handful of trusts where a steep increase in income has not led to a commensurate rise in removals from the waiting list.

The review has been triggered by concerns that additional waiting list payments are being driven by trusts changing their activity data recording and coding, meaning they can earn more without necessarily increasing activity levels or “clock stops” (appointments which mean a case is removed from the waiting list).

A government source said the Department of Health and Social Care was reviewing the growth in funding “to ensure value for money.”

A DHSC spokesperson said: “We inherited a broken NHS with waiting lists sitting at record highs. We are committed to getting better value for money, driving productivity, and delivering 40,000 extra appointments per week, including by listening and learning from trusts on the ground.”

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Source: HSJ, 7 November 2024