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NHS finance for dummies


Blog headlines

  • UK’s National Health Service teams up with the Radio Society of Great Britain to improve health and wellbeing
    4 March 2021

    This week's blog is by Paul Devlin, Emergency Care Improvement Support Team (ECIST), NHS England and NHS Improvement.

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

Friday, 22 March 2013

NHS finance for dummies

The HSJ’s coverage of the budget and former NHS finance director Noel Plumridge’s occasional articles on “underspend” are recommended reading for students of creative accounting, NHS employees and the general public.

A cynic might conclude that the government routinely publishes a politically expedient NHS budget but pegs real spending at a significantly lower level – £2.2 billion lower, say – so that the  Treasury can balance the books. 

We have no truck with cynicism here but we are nothing if not expedient, so without further ado here is the 2012/13 NHS Networks budget statement and forecast for the next financial year. Read this and it will help you understand the bigger picture.

In the interests of transparency and because neither our readers nor our finance team are financial experts, we have used plain English* and round numbers throughout.

2012/13 budget statement – NHS Networks

Total financial allocation: £2.2 billion

Ring-fenced funding: £1.5 billion

Surplus: £499 million

Income from wrongly addressed invoices to NHS Net: £15 million

Productivity target: 98% 

Quality premium: £1.49

Reinvestment in patient care: 37 pence (estimated)

Staff costs: £211

Assets: £3.72 (approximate value of unredeemed Tesco Clubcard points)

Total underspend: £2.19 billion

2013/14 forecast – NHS Networks

Total financial allocation: £91 billion

Total underspend: £151 billion

Balance (owing to the Treasury): £60 billion

Notes to financial accounts

Achievement – financial balance; not to be confused with real achievement

Allocation – total funding as evidenced in press releases and headlines such as “NHS Networks budget to exceed global famine relief spending for tenth year running”

Spend – actual NHS Networks spending as evidenced by aid workers and food parcels for staff

Reinvestment – cash left for Paul when the service run for Peter was decommissioned 

Ring-fenced funding – money that appears in total allocation but can only be spent to mitigate exceptional risks, such as invasion by killer bees, a clotted cream tsunami on the Cornish coast or the end of time (requires approval of secretary of state)

Surplus – system of credits or tokens roughly equivalent to Tesco Clubcard points; can be used for career advancement or balancing overall NHS budget; not suitable for spending on patients

Underspend – another word for “surplus”; cash you never actually had donated to a good cause of your non-choosing (eg defence budget, tax relief on beer, dairy product flood defences in the south-west)

*As defined in the government white paper entitled Telling it Like it Is: appropriate use of clear, concise and proportionate language to convey reasonable messages without causing offence to achieve an outcome close to or approximating plain speaking in any situation requiring written or verbal communication between individuals, organisations, communities and as yet undiscovered life-forms and entities irrespective of origin, culture, sexual orientation, political affiliation or choice of footwear

Editor’s note: All figures for NHS Networks are made up. Any similarity between these and figures made up by the government is purely coincidental.

For the serious financial news read Crispin Dowler's analysis in the HSJ (subscriber only access). 

trevor.jenkins@sept.nhs.uk says:
Mar 22, 2013 02:50 PM
Sounds about right. If the patient is at the heart of everything we do in the NHS, is that where the 37p goes?

A. Dummy
jpatterson says:
Mar 22, 2013 03:14 PM
Yes, subject to audit, of course.
PhilP says:
Mar 22, 2013 05:31 PM
No sequins and proscribing budget either. What a balanced accountant .... sorry, beancounter!