Daily Insight: Energising idea

The NHS is looking for a way to tackle cost pressures in the energy market – and a centrally negotiated contract could be a popular idea, according to a presentation last month.

There was “strong support” for this at procurement events last year, the national estates category council has been told. 

NHS England is said to be considering the idea, with plans to look into whether supplier capacity could cope, and how a mandated or endorsed framework would work.

The chief commercial officer was due to discuss a central contract with Amanda Pritchard. 

An NHS spokesperson said that given energy cost pressures and efforts to leverage collective buying power, it was looking at supply and contracting arrangements to agree a commercial strategy that delivers the energy at the best possible price.

The cost pressures are very real for trusts – both for gas and renewable energy.

Some were told last year to expect gas bills to quadruple, while HSJ revealed last month several of the largest providers had stopped buying 100 per cent certified renewable energy as costs skyrocketed. 

The squeezed middle

An integrated care board chief sparked a lively debate about the amount of autonomy ICB bosses are being granted by NHSE following a frank assessment while taking part in a panel discussion on Friday.

Speaking at the Nuffield Trust’s annual conference, Dorset ICB boss Patricia Miller said there was “a lack of freedom” and “a level of instruction which far exceeds” given to foundation trust leaders.

NHSE had, she said, even demanded to sign off the wording of the adverts for the ICB’s executive directors. “If we need that level of intervention then I might as well be a band seven,” she added.

The comment prompted applause from across the room, who sympathised with the suggestion that ICBs were the “squeezed middle” stuck between NHSE and providers, although some HSJ commentators said the comments was disparaging to band 7.

But the thrust of her overall argument, however, was certainly clear. “We need to change the conversations away from micromanagement and the delivery of targets” towards giving local leaders autonomy, she said.

Ms Miller also criticised the willingness of some healthcare leaders to work in the interests of a system, rather than just their own organisation.

The remarks are a timely prompt on the strength of feeling on this matter amongst the ICB leaders for Patricia Hewitt, whose review of how NHSE manages integrated care systems is due this month.

The former health secretary has already cautioned she is unlikely to recommend a radical restructuring of NHSE’s oversight role, but she can certainly have no complaints about the clarity in which Ms Miller expressed her views.