The must read stories and talking points from Wednesday

End of year bonus

As more trusts give up on their financial plans, a huge pile of cash is mounting up to reward those that can stay on track.

Under the control total system currently governing NHS finances, trusts that miss their financial plan have their allocations from the £1.8bn sustainability and transformation fund dished out to providers that do meet their targets.

In 2016-17, this created huge disparity between those that received bonus STF payments, and those that got nothing.

But with the overall deficit getting worse in 2017-18, the distortive impact looks set to be even greater.

According to the latest forecasts, there will be £780m of uncommitted STF at the end of the year (which is likely to increase – see below), compared to £420m at this stage last year.

Under the bonus pot rules, this cash will be divvied up between trusts that hit their control totals, on top of the money received from their original STF allocations. Around two thirds of trusts are likely to benefit.

As we saw last year, there will also be a handful of providers able to trigger huge bonus payments with one off income or balance sheet adjustments before the accounts are closed.

Looking at the monthly run rates of trusts still forecast to meet their control total, the pile of bonus cash is likely to grow larger still.

Beat the gongs

Jeremy Hunt has written to the prime minister calling for an overhaul of the honours system to help reward leaders who take on challenged NHS trusts, HSJ has been told.

The health and social care secretary is believed to be frustrated that the honours system, which rewards people with knighthoods, damehoods and other honours for their public service, is failing to recognise key players in the NHS who do more to turnaround failing trusts and improve patient care.

The letter is believed to have been sent to Theresa May in the last week. HSJ understands it included a list of senior NHS figures Mr Hunt believes are worthy of honours but were unlikely to receive them under the current system.

A source told HSJ the letter was designed to express Mr Hunt’s view that the honours system was “broken” and rewarded people who had chosen safe jobs rather than risktakers who face up to challenges of poor patient care and performance.

Recent recipients of honours include Dame Jackie Daniel, who led the transformation at the University Hospitals of Morecambe Bay Foundation Trust, and Sir Andrew Morris who turned around Wexham Park Hospital when it was taken over by Frimley Health FT.