State of the sector

Confidence that trusts have the capacity to meet demand for services over the next 12 months

• Almost four in five trust leaders (79%) were very worried (26%) or worried (53%) about whether their trust has capacity to meet demand for services over the next 12 months, which was nearly the same as last year (78%). These levels are significantly higher than before the pandemic (61% in 2019).
• Several trust leaders noted severe issues with bed capacity and recruitment in certain services, with growing wait lists compounding high demand. Respondents highlighted the need for longer term planning.

• The majority of respondents (96%) said it is very likely (45%) or likely (51%) that their trust will have to review responsibilities within non-clinical roles, with a view to optimisation in order to help manage or improve their trusts’ financial position.
• Almost nine in 10 trust leaders (87%) said it is very likely (32%) or likely (55%) that their trust will have to review responsibilities within clinical roles, with a view to optimisation.
• 85% of respondents said it is very likely (34%) or likely (51%) that their trust will have to reconfigure services to help manage or improve their trusts’ financial position.
• Relative to the other responses, fewer trust leaders (42%) said it is very likely (13%) or likely (29%) that they will have to close some services to help manage or improve their trusts’ financial position.
  
  

What is your biggest concern in relation to the trust’s finances over the next 12 months?

• Capital: Trust leaders noted capital as their biggest concern, managing the estate and high maintenance costs, the constraining impact of CDEL on availability of capital, and lack of capital for vital infrastructure projects. Respondents flagged that the ability to innovate is being hindered, limiting the extent of transformational change.
• Impact on staffing: Respondents frequently raised the issue of headcount reduction, delivering the financial position and its impact on staff wellbeing and patient care, and continued agency spend.
• Reliance on non-recurrent savings: Trust leaders noted the reliance on non-recurrent savings to deliver efficiency targets and raised concerns at being able to achieve a breakeven position in a sustainable way.
• Lack of autonomy: They raised concerns around the lack of autonomy in decision-making and the impact this has on ensuring service provision is reflective of population needs and setting realistic financial plans.