The must-read stories and debate in health policy and leadership.
- Today’s essential listening: HSJ podcast: The great coronavirus reconfiguration
- Today’s lengthy delay: How covid-19 may impact NHS elective waiting times
As the UK moves to much more significant social isolation measures, the NHS has seen further shifts.
It’s been confirmed that junior doctor rotations have been suspended. There remains uncertainty about NHS staff eligibility to be tested for covid-19.
Last week, the Care Quality Commission came under pressure to call off its inspections while the NHS grappled with the coronavirus outbreak. NHS Confederation said it would be an “inevitable distraction” for staff at a time when their attention should be elsewhere. Sir Simon Stevens also spoke up, telling the chief nursing officer’s summit event in Birmingham “the bulk of [the CQC’s] routine inspection programmes is clearly going to need to be suspended”.
On Monday morning, the regulator’s executive team decided it was time to call it quits and suspend its inspections where there are no immediate safety concerns while the outbreak rumbled on.
NHS Confederation said the decision would prompt a “sigh of relief” from front-line staff.
Speaking of cancellations, the NHS Confederation conference — which was this year combined with the NHS England and NHS Improvement-run Expo — has also been called off. The Manchester-based event was due to run on 10 and 11 June.
A notice on the event’s website said: “As our event was planned for June, we do not think it is appropriate to divert staff time during what we can expect to be a period of increased activity for the health and care sector.”
To a tee
In 2016, national leaders set up a five-year “sustainability and transformation fund” to try and get NHS providers back into balance, and release investment to help redesign services.
In the initial years, NHS England knew a large chunk of STF would be needed for “sustainability” (in other words, plugging annual deficits).
But the expectation was the provider sector would be back in the black by the end of 2016-17, enabling more of the fund to be released for “transformation” investment, into new models of care.
A policy paper from NHSE at the time said: “We intend that over the five-year period the split between sustainability and transformation requirements for local health economies will change. As the provider sector comes back into underlying balance under NHS Improvement’s supervision, the share of the funding available for transformation and new policy commitments will increase in subsequent years.”
As has been well documented, four years have now passed and providers haven’t gotten back to financial balance. Each year they have reported deficits of between £500m and £1bn, with the underlying position estimated to be far worse.
So, in the last three years, only a third of the fund has gone on the ‘T’ (though the proportion has increased slightly).
Data obtained by HSJ also shows the distribution of that money, with some areas receiving up to four times more per head of population than others.
Greater Manchester was far and away the largest recipient, despite NHSE’s repeated insistence that the devolution region’s dedicated £450m transformation fund represented a “fair share”.