What NHS England isn’t telling you, and more indispensable weekly insight for commissioners, by Dave West
Let’s be honest, as I sit around, biting my fingernails waiting for the unprecedented, early, two-year NHS planning guidance, it’s not worth doing too much analysis today.
With the summer over, though, plenty has been going on that will shape the environment for health and care commissioners.
The national NHS leadership (aka Simon Stevens) has now said openly that the government’s funding plans for the next few years – the “middle years” of the parliament, due for extremely slim growth – are not what it wanted. The NHS England chief executive has previously said the service needs a big capital infrastructure fund.
His point on general spending (which follows some successful noise making by NHS Providers) is a statement of the obvious, but is a notable shift in position in the build-up to the government’s autumn statement in November – when it could choose to do some extra borrowing for an infrastructure boost, or decide to “reprofile” and give the health service a less horrible time in those middle years.
As far as anyone can tell (and a meeting has been held in recent weeks between Theresa May, Mr Stevens and Jim Mackey) the new prime minister has no major new ambitions for the health service, though she is very unlikely to give way to the BMA.
Like many a politician before, she has indicated she would like the NHS to be quiet and stay out of the news – a doomed desire given the finances, A&E performance and the contents of sustainability and transformation plans (now with added public suspicion). I’m aware of no signal on whether she and chancellor Philip Hammond are minded to provide a much needed funding uplift, but it’s fair to say a win on capital/infrastructure is more likely than general spending.
The King’s Fund and Nuffield Trust have re-raised awareness about social care funding, and Norman Lamb has helped keep health and care spending on the agenda, too. The Conservative conference begins on 2 October – HSJ will be watching for rumblings there.
There’s a sense the wider NHS might back an autumn statement deal that gave money to social care over health, ideally with a mechanism to make sure the money doesn’t go into other local authority budgets: a rebranded revival of the better care fund – surely not?
Finally, led by our integration correspondent David Williams, HSJ has published a detailed leader column on the journey so far for the reforms of NHS business and clinical models envisaged in the Five Year Forward View. It is an excellent scene setter for the months and years to come.
Dave West, senior bureau chief