The must read stories and most important developments on Thursday

Looking after your STF

Attempts to control the NHS provider sector deficit failed miserably last year, which means a tougher approach is being taken in 2015-16.

With a helping hand/threatening fist from HM Treasury, trusts have been issued individual financial targets for the year, which if met, means they will quality for additional funding.

In a document sent to trust finance directors this morning, seen by HSJ, NHS Improvement said achievement of quarterly financial targets would be a “binary on/off switch” to secure access to trusts’ share of the “sustainability and transformation fund”.

If a trust achieves its quarterly year-to-date target, or “control total”, it will receive 70 per cent of its STF allocation, while the other 30 per cent will depend on performance against the headline waiting time targets for emergency, elective and cancer services.

Usually, trusts set their own financial plan (or target) at the start of the year after negotiations with their commissioners, so the new policy represents a significant scaling back of local control and decision making.

Looking at the STF in a positive light, it should give an extra incentive to trusts to regain control of their finances, as well as certainty around the level of central support/bailout funding which is deemed acceptable by national leaders.

And next week’s expected “reset” could help crystallise the targets in the public’s mind, and produce added pressure, and perhaps impetus, to deliver.

Based on the experience of recent years, where financial targets have quickly been missed, before being redrafted and missed again, this seems a risky strategy.

Many organisations may miss their targets for a multitude of reasons outside their control, bringing unfair scrutiny and pressure to bear on a system already creaking and lacking in confidence.


Under an acute umbrella

A leading GP provider in Sandwell and West Birmingham are apparently “not averse” to becoming salaried employees of an acute trust.

The high profile primary care-led “vanguard” provider, Modality, is considering whether its GPs could move under an acute trust umbrella if it aided service integration.

Naresh Rati, executive director of Modality, said he did not think many GP-led organisations were currently ready to be the lead provider in new care model arrangements.

He added: “Across Modality we’ve had this conversation about us moving under an acute umbrella and becoming consultant GPs under a salaried model and I don’t think my GPs are necessarily averse to that model, if that’s what it takes to get true integration.

“I’ve drawn up a [draft] salaried consultant GP contract and we’ve shared that amongst our partners to test whether they would be interested and I think they probably are.”

He said they would not necessarily be salaried to an acute trust, but “it could be that the GPs set themselves up as community provider type organisation” which would employ them.