Monitor publishes financial assumptions for 2012/13

Published on: 17th April 2012

Monitor has published its financial assumptions for 2012/13 which are used in the assessment of applicant Trusts and provide guidance for Foundation Trusts when producing their annual plans.

Monitor's assumptions are revised each year to reflect a number of updates on both cost and income pressures and risks that will affect all healthcare providers. Cost pressures are composed of pay costs and non-pay costs whereas income pressures arise from reductions to income uplifts.

Financial assumptions are used by Monitor to:

  • assess applicant trusts;
  • risk rate some investments and transactions carried out by existing NHS foundation trusts;
  • to evaluate additional requests for borrowing under the Prudential Borrowing Code for NHS foundation trusts; and
  • provide an estimate of the efficiency requirements which foundation trusts can use to guide their annual plans.

Monitor's assumptions about cost pressures are based on careful consideration of the likely pay and non-pay pressures in the NHS, including the latest economic forecasts published by the OBR, historic trends in NHS pay and prices, and stated government policy on public sector pay. Our assumptions about income uplifts are consistent with guidance in the Operating Framework regarding the level of tariff uplift in 2012/13 and beyond.

The table below details the sector-wide recurrent efficiency requirement facing providers based on these updates.

    2012/13 2013/14 2014/15 2015/16 2016/17
Acute Assessor 4.5% 5.0% 5.0% 4.2%  4.2%
Downside 5.25% 5.5% 5.5% 5.0%  5.0%
Non-acute Assessor 4.5% 5.0% 5.0% 4.2%  4.2%
Downside 5.0% 5.5% 5.5% 4.7%  4.7%

In addition to sector-wide efficiency requirements, for acute trusts Monitor will consider the impact of tariff income levers as outlined in the Operating Framework 2012/13 and the policies adopted by a trust’s commissioners. We will assess and apply any additional pressures from these tariff levers non-recurrently on a case by case basis to reflect the circumstances of individual trusts.

Individual providers will face their own specific circumstances and will, to some extent, be able to mitigate the risks reflected in Monitor's assumptions. Where mitigating actions are backed up by careful and evidence-based planning, Monitor will consider offsetting them against our assumptions.

Miranda Carter, Monitor's Assessment Director, said, "Monitor's has updated its  assessment assumptions to reflect the current challenges in the sector with growing demand for services, increasing cost pressures but only limited growth in funding". 

"Monitor's financial assumptions are consistent with maintaining the "bar" for achieving foundation trust status, which ensures aspirant Foundation Trusts have realistic business plans that are financially sustainable.”

"We recognise the scale of the productivity challenge, which will require trusts to deliver very challenging cost improvement programmes going forward.  It is important that these are delivered whilst maintaining or improving the quality of care to patients. To ensure quality is not compromised, it will be important for trusts to look at new ways of working and new ways of delivering services as they seek to address these challenges."

Notes to Editors

  1. Monitor's financial assumptions are reviewed and updated by Monitor's Board on an annual basis to reflect new economic and policy developments, such as the content of the 2012/13 NHS Operating Framework and the Chancellor’s announcements on public sector pay made in the 2011 Autumn Statement.
  2. A copy of the letter is available here.
  3. For further information please contact: For media enquiries please contact Nick Samuels on 020 7340 2446 and nick.samuels@monitor-nhsft.gov.uk or Michael Moruzzi on 020 7340 2438 michael.moruzzi@monitor-nhsft.gov.uk