HSJ’s round up of the must read stories and talking points from Monday

Mind the gap

When the star pupil starts to complain, it surely means there’s a problem.

Greater Manchester is one of the best equipped regions to deliver financial sustainability over the next five years, thanks to a jump start that was years in the making and a £450m transformation fund awarded by NHS England.

Yet Greater Manchester has warned that it cannot reach financial balance by 2021, due to a £176m gap in social care funding, and may have to raid its own transformation pot in order to prop up its day-to-day statutory services.

This is worrying stuff just six months into the five-year cycle, and obviously raises big question marks over the region’s ability to invest in the new models of care which will be crucial to delivering sustainability.

Meanwhile, leaders in Greater Manchester are set to commission an independent review of the current commissioning arrangements in the region.

The review could “ask questions” about the possibility of clinical commissioning groups moving within local authority structures, and will also examine the potential for more CCG and council commissioning functions to be carried out on a regional basis.

Never mind the gap

Meanwhile national NHS leaders have said areas should not use the fact that health budgets cannot be used to solve the social care funding crisis as an excuse for failing to press on with sustainability and transformation plans.

In a joint letter to the service published today Simon Stevens and Jim Mackey said: “While the NHS spending review settlement nationally was never intended to – and is obviously not able to – offset pressures in local authorities’ budgets, this fact is not a legitimate reason for councils or the NHS to stand in the way of action needed to put local health and care services onto a sustainable footing.”

Council officials and councillors have raised a variety of concerns about STPs. In one case, Birmingham City Council chief executive Mark Rogers, also the area’s STP leader, used an interview with HSJ to criticise NHS England and NHS Improvement for a “sort out the NHS first” attitude.

The letter also confirmed that the most advanced STP areas would be given more direct “influence and freedom” over how NHS England and NHS Improvement resources can be “better aligned and deployed” to support the implementation of the plan.

Mr Stevens and Mr Mackey also said the “most immediate task now is to focus on completing the contracting round by 23 December”.