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

Harder than we thought

Jeremy Hunt has admitted that a high profile pledge to have 5,000 additional GPs working in the NHS by 2020 now looks unlikely to be met.

Many predicted the target would be overly ambitious, and Mr Hunt said in an interview with The Guardian: “I got quite widely ridiculed when I made the pledge in 2015. I wanted to nail my colours to the mast of getting more GPs into the system. But it has been harder than we thought…

”This is not a pledge that we’re abandoning because it’s a very, very important pledge for the NHS and with general practice. It’s just taking a bit longer than I had hoped.”

It is a clear indication of how difficult recruitment within general practice has become, with national figures showing the number of GPs working in the NHS fell by more than 1,000 since the government’s promise was made in 2015.

To be fair to Mr Hunt, the result of the 2016 referendum on EU membership couldn’t have been factored into the pledge.

Dysfunction

PWC’s health team see a lot of NHS dysfunction up-close, so it’s concerning when one of their reports says a CCG has some of the worst problems they’ve ever seen.

That was their team’s conclusion after being sent into Cambridgeshire and Peterborough Clinical Commissioning Group (a CCG so big it is coterminous with its STP).

The review said: “Based on our experience of working with a large number of CCGs nationally, the issues facing the CCG in relation to capacity, capability and financial recovery, combined with the financial challenge facing the local health system, are among the broadest and deepest set of issues facing any CCG we have worked with.”

The issues include some old classics (continuing healthcare claims backlog - £10m), some universals (demand management scheme slips - £8.8m) and some local factors (Cambridge FT trying to activity their way out of deficit - £14.6m).

How did this happen?

“We note that there have been different individuals in the accountable officer role and four individuals in the CFO role in 2017-18”, the auditors said.

It added that the “governing body must take responsibility for the leadership and governance issues identified”, but the regulatory super-structure above the CCG must surely take some of the blame as well?

Nice one

With some “extremely expensive” new drugs and medical technologies expected to emerge in the coming years, there’s going to be some critical decisions required over affordability.

Sir Andrew Dillon, the chief executive of NICE, explored this theme in an interview with HSJ, noting that NHS England is likely to be “more and more” interested in the impact of his organisation’s guidelines as costs rise.

He revealed a new panel has been convened by NHSE, NHS Improvement and Public Health England to consider guidelines which would have a “substantial net resource impact”.

This will inevitably spark questions about independence, but Sir Andrew said the panel is intended for national bodies to ask questions and be aware of what’s coming, rather than attempting to ‘vet’ any guidelines.