HSJ’s round-up of the must read stories and debate in health

Kernow climbdown

Last week HSJ reported how Kernow CCG had been allowed to spend £396,000 on a new interim turnaround director this financial year. The CCG said it was required to make the appointment by NHS England, and the national body had been aware of the costs.

The story prompted a lot of criticism of the process and amount of money being spent on interims – one HSJ reader called the amount “obscene”, though others argued that a difficult and unpredictable job required experienced managers who cost more money.

The situation has since changed. On Wednesday it emerged that the CCG will have to revisit the whole “financial package” after NHS England decided it should be subject to new financial controls after all.

On 21 July (after Kernow’s appointment had already been given the nod) NHS England brought in a cap on interim pay as part of the financial “reset”, with approval needed for all interim CCG managers paid more than £600 a day.

NHS England sent a statement to HSJ after the original story was published saying the £396,000 appointment “will not continue at that rate” as it would not be compliant with the new controls.

It said that although it had approved the appointment, it did not approve the “financial package” because this was outside its remit at the time. The new controls made the financial element of the appointment part of its remit, so it had subsequently examined the Kernow case.

The CCG will now have to ensure the contract complies with the cap, or return to NHS England for permission to breach it.

Two-year tariff plans

NHS Improvement and NHS England have published new tariff plans covering a two-year period between 2017 and 2019.

Notably, they have again shelved plans for a marginal rate for specialised services. The national bodies previously tried to introduce the measure in the 2015-16 tariff, before providers revolted.

The measure was proposed again last year, for the 2016-17 tariff, but was dropped due to delayed implementation of a new currency framework. The new currency framework, called HRG4+, now looks set to be introduced from 2017-18, but the regulators said they “will not be introducing a marginal rate for specialised services in this tariff”.

Meanwhile, spending on maternity services could rise by £221m next year under proposals in the document.

Free guide: how to cut unwanted variation

A new guide from HSJ and Syncera looks at how reducing variation in healthcare offers both financial savings and the opportunity for trusts to improve care.

It includes a summary of a recent HSJ roundtable, video highlights from the contributors, and case studies from organisations making inroads into the problem of unwarranted variation