Stevens: Increased NHS budget will boost underfunded CCGs

The NHS England chief executive was speaking last night at the first HSJ annual lecture, held in conjunction with advisory firm FTI Consulting.

George Osborne announced the government had increased its planned funding for the NHS in 2015-16 by around £2bn in last week’s autumn statement.

Some £1.5bn of it is due to be allocated to CCGs and specialised commissioning budgets and NHS England will decide how to split it at its board meeting this month.

However Mr Stevens last night said there would be a “particular emphasis… depending on the decisions that are taken at the NHS England board meeting on 17 December, on helping those places that are furthest away from their fair shares of resources”.

Under the current CCG allocation formula and policy, adopted by NHS England in late 2013, around 95 CCGs are below their target allocation. A disproprotionate number of these are in deficit.

He said the remaining £450m would be used to introduce the new care models outlined in the NHS Five Year Forward View and “kick-start transformational change”.

Mr Stevens said there would be an “onus” on the NHS to demonstrate extra funds were being put to good use.

“The most corrosive thing for the health service would be if the perception gained footing that when you put resources in to get improvement you don’t obtain those results,” he said.

Mr Stevens also spoke about the £22bn efficiency savings he has estimated the NHS will need to make in the coming five years, saying “we don’t have a choice” but to achieve it.

He gave several examples of where savings can be made including less reliance on agency and temporary staff, cutting down on the amount of paperwork paramedics have to complete and making sure senior clinical decision makers are discharging patients at the weekend to avoid delays in freeing up inpatient beds.

He said he had met with a group of patients with neurological conditions who complained they “can’t get podiatrists and for some reason nurses are banned from cutting their toes”.

Reforms around pathology were overdue, he added, with Lord Carter’s review of pathology completed six years ago “mostly unimplemented”.

He said the fire service should more often help with falls prevention in people’s homes.

Mr Stevens said: “I think all of us forget the fact that we do live in an opportunity-rich environment when it comes to efficiency. Many of the practical measures that we need to take have been exhausted but in the round we have real opportunity still in front of us.”

He said NHS national bodies had a “trick to pull off” because they had to be “purposive” about making efficiencies but also need to “support emerging leadership to give people space to do that”.

He said it should be easier to move money to where it would have “most impact” rather than it being in a “series of funding silos”.

Giving an example in mental health services he said: “One of the things we know is that the demand for [more specialised] children and adolescent mental health spending tier 4 is going up because the availability of CAMHS 2 and 3 has been constrained or in some cases cut.”

Mr Stevens also warned the national financial environment meant there was little prospect for building hospitals in coming years, discouraging areas where this was part of their plan.

He said “too many” plans from “financially under the water” providers relied on this, while under “any feasible outlook for NHS spending” there will be no “massive hospital building programme across this country”.