Looking ahead at the financial situation in 2024
The main challenges for healthcare
In recent years we have seen an increasing demand for complex care. Due to an aging population combined with increasing medical capabilities, the demand for complex care will only continue to rise in the coming years. At the same time we are experiencing a huge shortage in the labor market across the full spectrum which poses challenges to us. Both in terms of recruitment and retention of colleagues. Our healthcare professionals are already experiencing the current work pressure as high, and although the percentage of sick leave went down in 2023, it is still higher than our target (4.9%). In addition, our resources available for care are under pressure. In the signed Integral Healthcare Agreement (IZA), it was agreed to limit healthcare spending. This will require significant transformation and means that we must:
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Prevent people from falling ill.
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Ensure that patients arrive at the right place fast.
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Organize care differently.
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Pay a lot of attention to engaging and retaining our (healthcare) staff.
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Implement innovations based on research.
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Offer differentiating education.
Transformation agreements and deployment of transformation resources
To provide appropriate care, the IZA places more emphasis than in the past on collaboration between health care parties, including across health care domains. To facilitate this, the IZA includes agreements on equal contracting for impactful care transformations. This allows us, as a healthcare provider, to submit transformation plans to health insurers, and if necessary request temporary transformation funds. These plans could be hooked onto our own initiatives for healthcare transformations and/or to regional representations and plans that are drawn up .
Concerns regarding inflation and CLA increases
The increase in our costs in 2024 and future years will not keep pace with compensation to be realized on the income side. Combined with the increase in capital costs due to our aging accomodations, this means we will be forced to make substantial financial adjustments in the coming years. We base this on the Healthcare of Tomorrow movement . In order to maintain our financially healthy position also in the short term, we must make the necessary choices throughout 2024 and in the budget for 2025 to redesign our operations differently, more effectively, and more efficiently.
Staffing development
The development of our staffing on the one hand depends on the healthcare demand, our research and education portfolio, and the amount of staff needed to deliver the necessary care and research and educational activities, and on the other hand, on developments in the labor market. Due to the currently tight labor market it is not always feasible for instance to optimize the staffing of operating rooms, which means that operations sometimes have to be postponed. In this regard we aim to employ as many workers as possible on a contract basis and to limit the use of external hires. The pressure on available resources and the tight labor market require us to exercise strict control of staffing and phase out the use of self-employed staff.
Significant investments in accomodation and ICT
Due to the age of our buildings and changing needs, we will be renovating and adding new buildings in the next ten years. To tackle these building and financial challenges in a proper way, we have drawn up an integral vision on accommodation . At present we are once again recalculating the financial aspect of the vision as a whole and having it validated externally. An important issue here is the development of sharply rising building costs over the past period. We shall not start with the next phase before it has clearly been concluded that the entire package of renovation projects is financially feasible. Considering the current extent of our cash resources we expect that additional financing will be sought as of 2026 approximately.
In the coming years we shall also have to invest in ICT due to the steadily increasing digitization of processes within UMC Utrecht, developments in the fields of e-Health, artificial intelligence (AI) and big data, and scheduled investments to replace IT components (hardware, system software, and applications).
