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Will the recent funding settlement for the NHS derail promises made in the long-term plan?

NHS England is reviewing the commitments made in the plan to see if they can be met, following the disappointment of the latest funding announcement and the financial ravages of the pandemic.

The government last week announced it would increase its pre-covid planned budget for the NHS in 2022-23 by £6.5bn and in 2023-24 by £3.6bn. This only covers about half as much as the NHS said was needed to cover covid costs, account for the elective backlog and other increased demand, make up for lost efficiency savings, and to maintain the improvements planned in the 2019 NHS long-term plan.

Senior sources — including directors in NHSE, which manages the NHS budget and priorities — said its officials would now need to review budgets and service priorities to decide which could be met.

Southern discomfort

Every integrated care system has areas which managers know are under pressure and difficult to sustain.

But it is rare for an ICS to admit it has 14 services which are “fragile and challenged” – including fundamental ones such as maternity, major trauma, paediatrics and critical care and a host of planned care.

But that is what Sussex ICS has done. A KMPG analysis of the opportunities in the system has recently been posted on the ICS’s website (without fanfare) and reveals not only the challenged state of many of the county’s services, but a hunt for extra elective capacity where planned surgery can be carried out away from A&E.

There are a few options in the county – including at Southlands Hospital in Shoreham-by-Sea, the Brighton Orthopaedics Centre and the community hospital in Uckfield. But the ICS also seems to be eyeing up possibilities at the tiny Queen Victoria Hospital Foundation Trust, which is exploring a merger with University Hospitals Sussex FT.

QVH has 10 operating theatres and no A&E. It currently provides a number of specialist services to the wider region. It is thought likely to lose adult burns inpatient services – which may be provided in Brighton where patients will benefit from other co-located services – which will free up one theatre. Running three session days could also provide more capacity, as could rationalising its off-site clinics at other hospitals.

But moving forward on any of this could be controversial, with a large number of governors opposing the merger and a pressure group concerned that the trust will be “asset stripped.” Even something as mundane as finding extra capacity is not a task for the faint hearted in Sussex.