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NHS faces a huge funding gap

Health sector regulator Monitor has warned that health services will need to change radically in order to secure the future of the NHS.

In its latest report Monitor has predicted a funding gap of around £30bn by 2021, which the health sector will need to close while providing good quality services to patients that are free at the point of use and fit for the needs of patients in the 21st century.


The NHS will have to achieve “more for less” at a higher rate than it ever has before, says the regulator. One “huge heave” will not be enough, and the NHS will have to ensure that improvements in productivity do not lag behind the rest of the economy.


NHS England has called for an “honest and realistic debate” on the challenge that the NHS faces. Monitor, as the sector regulator, is kicking the debate off with a report outlining the opportunities which are available to deliver better care and close the financial gap. These include:


  • Improving productivity within existing services;
  • Delivering the right care in the right settings, including increasing care in the community;
  • Developing new, innovative ways of delivering care;
  • Making ‘one-off’ reductions in capital expenditure and staffing costs;
  • Changing the way health spending is allocated (currently based on historic demand).


One way of meeting the challenge would be by encouraging new providers from abroad into the NHS to compete, or by getting NHS Trusts to adopt ideas from overseas which have been proven to streamline workflow and improve patient care.

David Bennett, Chief Executive and Chair of Monitor said: "Over the next eight years, the health sector faces its greatest financial challenge in recent times. We are all going to have to strain every sinew to meet it.

"While there are individual things the sector can do – like be more efficient in its procurement or introducing new ways of working in hospitals – what is required is a step-change. In short, the NHS must undergo radical change if it is to survive.

"Monitor, as the health sector regulator, will not only be supporting, but actively enabling changes that deliver better services for patients and reduce costs."