Certainty in Uncertainty

Mathematics is not my strongest skill.  I find NHS finance and incentives extremely complicated.  The following paragraph will confirm my ignorance and make NHS finance gurus laugh.

We have GMS/PMS/APMS Contracts, DES, QOF and Locally Commissioned/Enhanced/Integrated Service Agreements.  We have Standard Contracts/Block Contracts/Lead Provider Contracts.  There is PBR, BPT, Quality Premiums, CQUINS.  We have various pots of funds for Pilot, Vanguard, Demonstrator, Test beds, Innovation sites and the lately the Sustainability and Transformation Fund access through the STP Planning process.  What a lot of acronyms!  (Please note I have worked hard to put links to help describe them all!)

I can’t pretend for a minute I understand it all.  I do try because I am always trying to spot funding that could be capitalised on to support diabetes.

To add the complexity of funding flows through the enormous NHS organisation.  We now can add uncertainty.

Simon Stevens could not have been clearer in his interview with Andrew Marr prior to the country’s decision to leave the European Union. He made clear that the uncertainty of leaving the EU would create uncertainty for the NHS.   

Only time will tell.  I’ll admit I am not great with uncertainty.  I felt things were just beginning to come together after all the cards were thrown in the air further to the Langsley debacle in April 2013.  In particular I like the “Diabetes Aide Memoire” to support Sustainability and Transformation Planning.  I like how, in 2 pages, we have a clear job list that we can work on together, collaboratively.

No one will be more delighted, when I am laughed at for being a worry-pot this time next year.  But I am concerned.  I am concerned about whether the funding required to underpin the improvement work outlined in the “Diabetes Aide Memoire” is still going to be available come April 2017 and beyond.

However, in a time of uncertainty let me give you some certainty.

Unless obesity rates decline, physical activity rates increase and the diabetes prevention programme succeeds, then the 3.2million people with diabetes in the UK, will rise to 5million by 2025 and the current 10% of the NHS budget will need to rise to 17% by 2035. 

The other thing I am certain about is the commitment of all NHS staff.