The must-read stories and debate in health policy and leadership.
- Today’s integration insight: Tussles for ICS influence are coming soon
- Today’s bonus podcast: Picking the next NHSE chief – a conversation with Jeremy Hunt
First, be prepared for the return of “financial disciplines”. Uncustomary Treasury largesse brought on by covid meant NHS trusts have had their costs met and their efficiency targets suspended during the pandemic. That is coming to an end.
The second half of this year will see the same basic financial framework as the first half of the year, but the savings ask will be “slightly tougher”.
This will mean Mr Kelly and his fellow NHS England execs are prepared for the challenging conversations with Treasury mandarins in the run-up to the autumn spending review. The NHS will need plans for how it will cut costs and boost productivity covering the next three to four years.
Second, be prepared to submit your capital plans, Mr Kelly said. NHS England is going to come calling “pretty soon” for details of how much capital each integrated care system thinks it will need. And they want to know where it will be spent, whether it is replacing decrepit machinery or building digital infrastructure to enable transformation.
This will be a key part of the intelligence and data collected by Skipton House to help it “keep making the case to government” for “appropriate” capital investment. And it will mean Mr Kelly can show Rishi Sunak and his acolytes not only where the money is going, but which roofs it is paying to fix.
The Independent Reconfiguration Panel has generally provided a useful fig leaf for ministers approving controversial reconfigurations. It enables them to point out that the proposals have been carefully examined and backed by an independent body, and therefore should go ahead.
So there was some surprise that the IRP was lined up for abolition in the forthcoming health bill. Health and social care secretary Matt Hancock wanted powers to intervene earlier – at the moment councils have to refer reconfigurations to him.
Now that has changed: the IRP looks likely to survive although it is less clear what, if any, powers Mr Hancock wants to add to his portfolio and what would be the limitations around this.
Earlier intervention by ministers raises the spectre of systems having to guess what will be acceptable before they push forward with any changes and has been criticised by several influential people. NHS Providers has gone so far as to suggest this could prop up unsafe services.
If Mr Hancock pushes forward with this, expect the NHS to make it very clear who has made what decision and what the consequences of that are.