By Pash Sonigra on January 31, 2025
Quarter four means budgets. Every team starts with a bit of reflection, a stocktake of where they are and a whole lot of planning in the hope that next year, they’ll be in a better position.
Towards the end of last year, we knew the needle was shifting strongly towards cost savings being the priority across the board. When we spoke to you, a whopping 64% (up from 2023’s 11%) said that cost savings were your top concern and where your teams were focused.
The challenge of short-term funding cycles
While budget planning is firmly on the agenda, with cost savings as the overarching priority, I want to step back and highlight the difficulty of working year-on-year. The short-term nature of NHS funding cycles puts such an emphasis on annual targets and deficits that it really discourages long-term workplans for impactful patient outcomes.
Budgets are finite, and there’s always a balancing act of where money is invested to achieve in-year gains. In my experience, financial directors won’t readily sign off plans that don’t show in-year cost improvement, and that’s where I sometimes feel instead of playing chess, we’re expected to play checkers. For example, we know work in COPD is not an in-year project; it spans the whole health system and needs investment to realise long-term savings and prescribing efficiencies to improve patient’s quality of life.
Finding solutions
Overcoming these challenges requires an NHSE-wide shift in perspective. There’s a need to develop more universal incentives (outside of QOF) to reward, benchmark and evaluate long-term return on investment for medicines optimisation initiatives.
Whole system initiatives can help! Taking a pathway approach over an individual sector can deliver wins, but once again, we get into the challenge of managing in-year and divisional budgets over whole system gains. Why? If there were one thread of communication, those quick wins and cost-cutting optimisations we used to enjoy yesteryear would have the potential to be automated. Now, isn’t that something to think about?
It’s easy to look at how the system should work, in reality however, we need to make the system work for us. I understand there are pockets of good practice up and down the country where they have been able to progress joined-up approaches to support patient outcomes.
The balance we have to strike
Supporting patient outcomes is our objective! Whilst cost savings is the big, hairy (and often scary) monster looming behind our office chairs, our job is to balance those with the right outcomes for our patients.
We know it takes time out of already stretched GP teams day-to-day, we know patients don’t like to chop and change without good reason, and we know the NHS is up against it. So, when it comes to budget planning this time round, I’d love to know what’s on your workstreams – How are you going to strike the balance?
More importantly, will you have the courage to try something new?
A collaborative partnership
Get in touch, and let’s see if our resources can help you start 2025-26 quicker off the mark.
If you’d like to discuss the topic in more detail, reach out to Mahesh Mistry on LinkedIn or by email.
