Financial pressures on the NHS are harming community-based services, while some acute services are being shielded from cuts, putting the NHS ‘Five year forward view’ at risk, according to an analysis by The King’s Fund.
The independent health charity looked in detail at the impact of NHS and local authority public health cuts on four services — testing and treatment for sexually transmitted infections, district nursing, elective hip replacement and neonatal care. It found that financial pressures were having the biggest impact on patient care in district nursing and genitourinary medicine (GUM) services.
However, spending cuts have created opportunities for innovative ways of working that mean some GUM services, which would have been provided in specialist clinics, are now being offered by community pharmacists, community nurses or GPs, it says.
The report, ‘Understanding NHS financial pressures’, published on 14 March 2017, says: “These models are seen as positive by some, but others expressed safety concerns over the reduction in specialist clinician input.”
There was significant variation in GUM spending at a local level, the analysis found, with some budgets cut by as much as 20% since 2013–2014. Sexually transmitted infection prevention and outreach work, including encouraging young adults to come forward for chlamydia screening, had also been reduced, it says.
“Our findings create a fundamental challenge to the direction of travel set out in the NHS ‘Five year forward view’ and the implementation of new models of care,” the report says.
“With acute services, such as hip replacement and neonatal care, relatively protected so far, while some community-based and public health services like GUM and district nursing have been cut, the NHS appears to be moving further away from its goal of strengthening community-based services and focusing on prevention, rather than making progress towards it.”