The must-read stories and debate in health policy and leadership.

When back in March the NHS tore up its regular finance and spending plans to cope with the pandemic, it sparked what looked like the start of a quiet revolution.

Of course, the changes were temporary but there were no more control totals, no more activity targets and providers handed fixed sums of cash with top-ups instead. It was quickly welcomed.

Conversation slowly developed about how these changes could be cemented or at least incorporated into future planning. 

However, such curiosity may have been quelled with the announcement by NHS England/Improvement that a new system of financial incentives will be used to drive performance and capacity from September.

Systems will be responsible for hitting activity levels set out in the phase 3 recovery letter, with penalties for shortfalls and rewards for excess performance. 

Moving this responsibility beyond individual providers is a huge change that may catalyse system relationships and accountability. 

However, for those hoping for more root and branch change of financial architecture, this distinctly familiar system of penalties and bonuses is perhaps not the coup they dreamed of. 

Farewell to ‘big event’ inspections?

“Disruptive” Care Quality Commission inspections could be on the way out as the regulator favours a move towards more ‘intel-led’ monitoring of services.

CQC chief Ian Trenholm, in an exclusive interview with HSJ, said he wants to move away from inspections being a “big event” for providers in a bid to ease some of the burden on the NHS.

During winter, CQC inspectors will be focusing on “safety, access and leadership,” and downplaying the “effectiveness” and “responsiveness” of services, he said.

Mr Trenholm also revealed he is sceptical about the need for an independent patient safety commissioner, as recommended by the Cumberlege Review, and that the regulator will be launching more collaboration reviews of systems.