NHS finances are almost at breaking point. Since 2010, the unprecedented slowdown in funding growth and rising demand have made it increasingly difficult for the health service to live within its means. In the past, some hospitals have received extra financial support from the Department of Health when they have overspent, but the latest NHS planning guidance signals a shift from this approach by asking providers to balance their budgets by the end of 2016/17.
But what does this mean for people who access health services, and how can they examine the effect of financial pressures on their local health system?
Health care systems around the world have to take decisions about which services and treatments to provide and for whom. These decisions – sometimes referred to as ‘rationing’ – are taken at many levels: by national bodies; by local commissioners and providers; and by clinicians. While some decisions are explicit (agreed in law or policy) others are less easily identified as they are based on individual judgements.
Commissioners, providers and clinicians base their decisions on a range of factors