NHS cuts put cancer targets in jeopardy

NHS foundation trusts – a supposed marker of excellence in the NHS – are predicting a fall in their income, with an impact on how they deliver services to patients.

Trusts have told the regulator they expect a tough next three years, with more than a quarter (26 per cent) of 129 foundation trusts saying they were at risk of breaching key standards.

These included targets on cancer, superbugs like MRSA and services for the mentally ill.

Health Secretary Andrew Lansley has scrapped several NHS targets brought in under Labour, including that patients wait no more than 18 weeks for hospital treatment after GPs' referrals.

The four-hour A&E waiting time target has also been relaxed, so trusts now have to hit it 95 per cent of the time instead of 98 per cent.

Despite this easing some of the pressure, yesterday's report said some foundation trusts still remained at risk of breaching governance standards.

Altogether 23 trusts have already declared a risk to cancer targets, in particular the 62-day target from GP referral to treatment for cancer.

Nine trusts have declared a risk to their target for cutting MRSA, six to the target for cutting Clostridium difficile (C diff) and three mental health foundation trusts on a target relating to care programmes.

The Government has pledged to protect NHS funding but, at the same time, all trusts have been told they must find 15bn to 20bn in "efficiency savings".

Critics argue this cannot happen without cuts to jobs and front-line services.

The Royal College of Nursing (RCN) has gathered evidence from more than 100 organisations which show about 11,000 jobs are under threat.

These include staff being made redundant, not having their posts replaced when they retire or leave, and trusts imposing recruitment freezes.

The regulator said it expected an increase in regulatory action against trusts who become in "significant breach" of their financial commitments.

About one in three trusts are predicting a decline in their financial risk rating and while income growth of 1.7 per cent is forecast in 2010/11, income is expected to fall by 0.8 per cent over the next three years.

The report added: "Based on our review of the plans we believe there is an increase in the level of financial risk across the whole foundation trust sector.

"This was anticipated given the tougher economic conditions foundation trusts will be operating in, and as a result we expect to see an increase in regulatory action based on financial concerns."

The report said trusts have historically "struggled" to meet their cost-cutting plans and the latest plans "are more demanding than in previous years".

However, the Royal College or Nursing report also said proper planning should make the plans achievable.

A spokeswoman for the Department of Health said: "We have set out in our recent white paper that all NHS Trusts will become foundation trusts and will have greater freedoms to concentrate on developing services that meet local needs.

"However, all providers of NHS services are expected to improve healthcare outcomes, and meet ongoing performance requirements.

"To support the NHS in delivering high quality care, the Government has committed to a real terms increase in NHS funding each year.

"In order to maximise funding for front-line services, we have pledged to reduce radically the costs of NHS bureaucracy, including cutting NHS management costs by over 45 per cent and significantly reducing the number and cost of our arms length bodies," said the spokeswoman.