The must read stories and biggest talking points in the NHS from Friday

Nuff’ said

Despite system leaders previously accepting that provider efficiency savings of 4 per cent are unachievable, that’s exactly what they’ve been pressured to sign up to.

In a new report on NHS finances, the Nuffield Trust says providers have only managed savings of 2 per cent in recent years, and would have to double this rate to achieve the “control totals” mandated by NHS England and NHS Improvement for 2016-17.

Savings of 2 per cent are widely deemed to be a realistic ongoing target for the sector, as outlined in Lord Carter’s report on NHS productivity, and by former Monitor chief executive David Bennett.

Jim Mackey, the current chief executive of NHS Improvement, also called for a “more realistic efficiency ask” for providers in an interview with HSJ last November.

Report author Sally Gainsbury says there’s “little reason to believe” that cost cutting of 4 per cent is achievable or sustainable – it has never been done before – and there “does not seem to be a credible plan B”.

The report also made important observations on commissioning budgets, which due to tweaks in the payment tariff are on course to overspend by £1.2bn in 2019-20.

All in all, it was a pretty bleak assessment of a service in deep trouble, and it was hard not to read a sense of defeat in the generic response that came back from NHS Improvement: “The NHS faces serious financial challenges, and the financial reset announcement made recently set out our approach to a number of these.”

Homes discomfort

At the NHS Confederation conference in June, NHS Improvement chief executive Jim Mackey said plans were being worked on to build 22,000 affordable homes for staff on excess NHS land in coming years.

But commissioners in London now fear their plans to build afforable accommodation on surplus land at Barts Health’s Whipps Cross hospital site could be scuppered – because the trust has been placed in NHSI’s new “financial special measures” regime.

The regime was part of last month’s financial reset, and the regulator has the option of removing control over key financial decisions from trusts in the regime.

Waltham Forest CCG is worried that “the trust could lose its financial autonomy if it cannot demonstrate significant improvement in its finances”, and as a result the land could be “sold to the highest bidder” as a short term fix.