The essential stories and talking points in the NHS

History in the making?

Theresa May has said the government will reveal a new “sustainable long term plan” for the NHS over the next year, which will be backed by “a multiyear funding settlement”.

At the Commons liaison committee on Tuesday evening, she backed calls in recent months from Jeremy Hunt for a long term funding settlement and an “end to annual top ups of the NHS budget”.

The announcement received little coverage relative to its importance, but HSJ editor Alastair McLellan says the plan could be a historic moment for the NHS.

In his leader, he writes: “In January 1988 Margaret Thatcher appeared on Panorama to announce the review of the NHS that led to the internal market reforms. Almost exactly 12 years later Tony Blair chose Breakfast with Frost to declare NHS funding should be increased to match the EU healthcare spending average.

“Time will tell if Theresa May’s appearance in front of the Commons liaison committee… will take a similar place in the service’s history.

“What unites all three interventions without question is that they were all made with the aim of binding in wavering cabinet colleagues to the stated objective. Mr Hammond and the Treasury now have no choice but to back the idea.

“Quite how generous they will feel when it comes to providing the necessary funding is another matter – and an absolutely critical one.”

Midlands of opportunity

On Sunday, University Hospitals Birmingham Foundation Trust will take over its neighbour, Heart of England FT, to create one of the biggest trusts in the country.

The deal, signed by both boards this week, has been on the cards since UHB chief executive Dame Julie Moore took over leadership of HEFT in 2015.

Like other big mergers in recent years, UHB has been encouraged by regulators into the merger, which is seen as the solution to HEFT’s long running performance and financial difficulties.

However, unlike, say, Frimley Health, Dame Julie has said she’s not been able to extract any promises of financial support from the centre, despite trying.

In the short term, this will mean absorbing HEFT’s sizable deficit into the new organisation, which will keep UHB’s name.

While there are no extra funds agreed now, Dame Julie hinted that future applications for capital funding (to fix or replace HEFT’s ageing estate) could be viewed favourably.

With talks in the upper echelons of government about a long term funding settlement for the NHS (see above), the new, bigger, organisation will likely lobby hard for its share of any additional money.

Meanwhile, the trust will turn to back office consolidation and UHB’s superior reputation to plug staffing gaps at HEFT hospitals to close the financial gap.

The merger marks a remarkable period of consolidation in Birmingham and Solihull in recent years.

Birmingham Women’s and Children’s FT was formed in early 2017, and three of the area’s clinical commissioning groups will also become one on Sunday (not to mention GP super-partnerships).

Further structural changes are unlikely in the foreseeable future, but mergers could be just the start of changes in how services are delivered in the region.