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Mackey blunt on the budget 

A debate about what the NHS can deliver within its current funding envelope is required unless more money is announced in the budget later this month.

That’s according to outgoing NHS Improvement chief executive Jim Mackey, who fired a warning shot to ministers ahead of 22 November, in his speech to hospital managers at the NHS Providers conference.

Mr Mackey, who leaves the regulator later this year, spoke candidly about the need for a “reset” of expectations about what the NHS should be asked to deliver if no extra money is forthcoming from the Treasury.

He described the health system currently as “juggling hand to mouth”.

While he argued control totals and the sustainability and transformation fund had been effective policies to improve NHS finances, he said they were only short term measures that “can’t work forever”.

It will be interesting to see if Simon Stevens follows a similar tack – or goes further – in his speech on Wednesday morning. Follow HSJ Live from 10am to find out.

During the post-speech Q&A, Mr Mackey, who grinningly said he “can’t wait” to resume his job at Northumbria Healthcare Foundation Trust, also revealed he believes the NHS is run too much by the centre.

He said he was a natural “devolver” and vowed not to allow the centre to micro-manage the way he operated at his trust when he gets back there.

Mr Mackey ended the session with a bit of insight into life as the NHS Improvement CEO.

Asked by BBC Radio Four’s Sarah Montague about his experience in the job, he replied: “Everyone knows I never expected to enjoy this – I’ve tried to do my best and help out. I’ll find something next year, when I’ve had a chance to think, that I enjoyed.”