HSJ’s round-up of Thursday’s must read stories

Deficit deterioration

The admission that NHS trusts were going to miss their financial plan for 2016-17 was always going to come, so perhaps it’s a victory of sorts that it’s taken until February.

Research by HSJ has revealed that providers have indicated a year-end deficit approaching £1bn to NHS Improvement, following a deterioration of around £280m over the last few months.

This would significantly breach the maximum £580m deficit “control total” set by national leaders, although it is understood the regulator has since managed to improve a number of the forecasts following discussions with trust boards.

It is not yet clear to what extent the overall forecast has been reduced, or by what means.

For the first time in public at least, Jim Mackey, the NHS Improvement chief executive, has admitted the £580m control total will not be met.

The aim of the game will now be to stay within the £800m risk reserve that CCGs have been forced to hold back from their allocations.

Achieving this will require significant one-off transactions to boost income, however, as well as the bulk of providers’ backloaded savings plans coming close to delivering in full.

County-wide CCG shake-up?

A single entity could be established to commission all health and social care services in Lancashire, with a councillor potentially given the casting vote on its board, a new report has proposed.

The PwC document, commissioned by Lancashire county council, suggests a new “integrated commissioning authority” should hold a single budget and take over the strategic commissioning function from the county’s eight CCGs.

The report does not specify what the future of the CCGs would be, but refers to the new commissioning body as a “partnership between the county council and health partners”.

Senior NHS figures in the region have told HSJ it appears to set out a vision of local authorities “taking over” health services, and said they have not been involved in the process. The proposals would need to secure their backing to be taken forward.

Amanda Doyle, accountable officer at Blackpool CCG, said: “None of the organisations within our STP had input into, or sight of this report before it was published.

“It contains a lot of assumptions and some of the proposals would be outwith legislation.

“From my point of view I’m really supportive of the principle of aligning health and social care commissioning, and we have been working on an integrated strategic commissioner for the county. We will continue that work with the council.”

The report also suggests social care and public health provision would transfer to NHS trusts by 2019, creating five integrated care providers described as “wellbeing corporations”.

The document will go before the full council next week, with the recommendation that a working group undertake a detailed review of it.