The King's Fund: Reforming the finances of the NHS (15 December 2020)

Summary

It is a time of transition in NHS finance. The planned recovery from years of deficits and debts that plagued parts of the NHS in recent years has been hit by the enormity of the COVID-19 shock. Alongside this planned recovery, the NHS has been moving away from its decades-long journey toward competition between individual organisations and using market-like approaches to improve performance, to a design based on collaboration and improving population health.

Before the COVID-19 pandemic, the NHS was working to restore financial health and deliver on fundamental reform; now, it must achieve these objectives with the added challenge of recovering from the damage of COVID-19.

In this article, The King's Fund looks at the history of NHS finances over recent years to draw out learning for this new design. It will be important to apply this learning if the system is to avoid the recurrent ‘resets’ to NHS finance that have been necessary but have only provided temporary solutions, and deliver a new approach that is consistent with the wider objectives of collaboration and integration.