HSJ’s round-up of Friday’s must read stories and debate

Bridging the gap

NHS organisations in Hertfordshire and Essex are unable to “accept” their control totals for the next two financial years, according to the latest STP to be leaked to HSJ.

The Hertfordshire and west Essex STP says the area faces £42m and £51m gaps between its “aggregate control totals” and “aggregate of plans” in 2017-18 and 2018-19 respectively.

The plan also says there is “significant uncertainty about the ability to maintain the planned year-end financial position for 2016-17” – putting the ability for the STP to succeed at risk. The three acute trusts in the area have a history of significant financial problems, and all were running deficits in quarter two of this financial year, but it’s not clear which organisations were not able to accept their control totals.

The STP says it should be able to return the health economy to financial balance by 2020-21 by saving “at least £452m”, but the plans still left “a total system gap of £101m which is attributable directly to social care”. “Further work” is being carried out to help close the control total funding gap.

One source involved in the STP process told HSJ the project had become an “unedifying mess”. They said the first version of the plan was described as a “car crash” by national bodies and the second submission was “panned”.

HSJ’s Dave West said the document indicated both the severity of problems in Hertfordshire, and the gap between some STP submissions and the published summaries. Meanwhile, King’s Fund chief executive Professor Chris Ham said the challenges facing this STP were “not unique and all STPs need to be stress tested on finance and service plans”.

The STP is due to be officially published on Monday.

Triple trouble

In his latest analysis of NHS waiting times performance, Rob Findlay writes: “Back in October 2012, England was comfortably achieving its new 18 week target, with 92 per cent of the waiting list extending just beyond 16 weeks.

“But then the waiting list started to grow, and waiting times started creeping up. A year later, waiting times had risen by about half a week. The following year, another 0.6 weeks. The year after that, about the same again. A pretty consistent picture. And that brings us up to October 2015.

“October 2015 is special because that was the month when England started breaching the 18 week target again (if you factor in non-reporting trusts). And then waiting times really took off.

“In the following 12 months, according to figures released this week, England’s RTT waiting times rose by 1.5 weeks. That’s treble the previous rate of growth.”