HSJ’s summary of the day’s must read stories
- Today’s must know: CCGs claim rationing decision based on Right Care programme
- Today’s talking point: Dalton – Scrap national targets and merge CCGs to speed service change
- Today’s risk: Teaching trusts placed on watchlist over bullying and leadership concerns
The Dalton forward view
Never one to shy away from innovation and bold policy suggestions, Sir David Dalton has set out how the NHS can achieve the service changes promised by the Five Year Forward View much quicker than has happened so far.
“We all praised what the forward view wanted us to do – but sadly we are behind on organising how it can be delivered at pace,” the Salford Royal and Pennine Acute boss says. “Despite good work on integration and new models of care, it is taking us too long to deliver improvements.”
In an exclusive article on hsj.co.uk, the three-time HSJ Top Chief Executive describes 10 ways to get the 5YFV back on schedule.
He proposes the removal of provider trusts’ “right of veto” over change and a large reduction in the number of clinical commissioning groups.
Sir David also suggest replacing national targets with locally selected indicators, as the current system “distorts real priorities” with “diminishing returns”.
Technology, social care and primary care are also picked out as areas requiring greater focus and investment.
Rationing row part two
In the sequel to three CCGs’ high profile rationing row, we find one of the groups saying the decision to restrict knee and hip operations was a result of advice from a higher authority.
Redditch and Bromsgrove CCG, one of three Worcestershire commissioners accused of rationing the services without “clinical justification”, has said their hand was guided by an official from NHS England’s Right Care programme.
In a statement to HSJ, the CCG said it worked with an NHS England appointed partner to understand how to use Right Care data, which was subsequently used by the CCGs to make their decision on hip and knee ops.
Right Care is a programme launched by NHS England to help commissioners tackle “unwarranted” variation in care. It’s had different iterations over the years but the most recent version has seen CCGs receive data packs that compare spending, activity and outcome measures for certain procedures between commissioners with similar demographics.
According to Redditch and Bromsgrove, the packs for it and South Worcestershire and Wyre Forest CCGs showed they had higher spend and activity compared to their peers, indicating they could make £2m in savings.
The Royal College of Surgeons originally condemned the CCGs for using the Oxford scoring system to decide which patients are eligible for operations. It has now emphasised that Right Care data should not be used to determine target numbers for treatments.
With 209 RightCare data packs out there, one wonders how many other CCGs have been advised to use them in the same way.
In his latest expert briefing, HSJ’s finance correspondent Lawrence Dunhill sounds the alarm ahead of the release of NHS finance figures for quarter three of 2016-17.
He says: “A letter sent out by NHS Improvement last week signalled that bad news is coming on the financial plan for the provider sector. The regulator paved the way for some uglier performance figures than we got last time.”