The must read stories in health today
- Today’s must know: Mackey intervenes in escalating contracts row
- Today’s risk: ‘Very few’ NHS contracts agreed after ‘challenging’ negotiations
- Today’s talking point: NHS England to investigate Staffordshire contracts following Cambridgeshire failure
Contract negotiations turn ugly
There were no fewer than three big finance stories on Thursday, with NHS England looking increasingly like the baddies.
First, angry (and influential) teaching hospitals warned that new conditions imposed by the national body on quality incentive payments will put efforts to bring the provider sector into financial balance this year at risk.
Trusts also insisted they are incompatible with the basis on which providers accepted their 2016-17 “control totals”.
And just as one finance director warned that the new conditions would “play out in contract negotiations” between providers and commissioners, an email was being fired off to trusts from NHS Improvement, saying that “very few” contracts have been agreed.
Contracts were supposed to be signed last month, but Bob Alexander, NHS Improvement’s executive director of resources, said on Wednesday night negotiations have been “very challenging” and the timetable for operational plans to be submitted would have to be delayed.
It already seemed clear there were tensions between NHSI’s priorities and those of NHS England, and that was probably more than enough by Thursday morning.
But then NHSI boss Jim Mackey stepped into the row, saying that commissioners that have made “unrealistic” offers had until Friday come up with new proposals.
He also confirmed that providers were “very unhappy” with NHS England’s proposals for quality incentive payments in 2016-17, and said NHSI was in discussions with its NHS England to try to find a solution.
So with the NHS finances for 2015-16 still a long way from being resolved, things are already looking ugly early in 2016-17.
Two reviews are better than one
NHS England has confirmed it will launch a second review into the failed Cambridgeshire and Peterborough older people’s services contract.
The first was published last week and provides a very readable account of why the deal collapsed.
The new one will look at some other contracts which share some characteristics with the Cambridgeshire deal. Two big ones in Staffordshire will be included, but others might be too.
The second stage review will also examine the roles of the external advisers brought in by Cambridgeshire and Peterborough CCG on the project – Deloitte, the Strategic Projects Team and Wragge and Co have all been named.
The CCG’s own leadership will be scrutinised. Plus NHS England’s new review will also assess the Department of Health’s gateway process, which looked at the procurement before sign-off.
That last point makes it pretty contentious in terms of the internal politics of the NHS.
It appears as though NHS England is still working out what is and isn’t included in the review, but so far there’s no mention of any review examining the role of NHS England’s regional team, which had an oversight role in relation to the CCG. Also, will this latest review look at the role of Monitor, which signed off the providers’ business case right before the UnitingCare Partnership contract was signed?
If NHS England isn’t going to look at all that, someone else probably should.