HSJ’s round-up of Tuesday’s must read health stories

Piecing together the STP patchwork

NHS England has announced the individuals appointed to lead ”sustainability and transformation planning” in eight of the 44 geographic “footprints” across the country.

Work to plan the five-year transformation of NHS services in two of England’s biggest cities is to be led by local authority chief executives – the Greater Manchester footprint is headed up by Sir Howard Bernstein, chief executive of Manchester City Council; while the Birmingham and Solihull footprint is led by Mark Rogers, boss at Birmingham City Council.

Other STP patch leaders who will be familiar to HSJ readers include Royal Free London chief executive David Sloman and Sir Andrew Morris, chief executive of Frimley Health.

NHS England also confirmed the 44 patches, which are exactly the same as revealed last week by HSJ.

Our map also shows the CCG membership of each patch and the anticipated leaders of some further patches.

The real size of the deficit

Tuesday was not a day of easy reading for those tasked with trying to keep the NHS provider sector’s finances from total collapse.

The Commons public accounts committee laid into the Department of Health, NHS arm’s length bodies and the Carter review for the lack of “urgent action to put struggling trusts on a firmer financial footing”.

The influential group of MPs accused the government of being too slow to address acute trusts’ spiralling deficits; said there was “not yet a convincing plan” for closing the £22bn efficiency gap by 2020-21; and called data used by Carter review to assess hospital efficiency “seriously flawed”.


Meanwhile, on hsj.co.uk NHS Providers chief executive Chris Hopson has written about the uncomfortable choices facing the health service in the next few years.

Mr Hopson writes that in 2015-16 “the real provider sector deficit, after central financial support, capital/revenue transfers and balance sheet adjustments, is nearer £4bn than £3bn”.

While in 2016-17 “the best outcome we can currently envisage is reducing the aggregate provider sector deficit to £500m”.

Looking further ahead: “We really do now face a choice for 2018-19 and 2019-20 of investing more in the NHS in those years or reducing the service we provide to meet the budget available.”

Cynicism over vanguard winners and losers

The revelation from HSJ’s interview with Samantha Jones, published on Monday night, that “not all of the vanguards will get access to transformation funding” next year has provoked interesting debate among HSJ readers.

While some subscribers applauded the “pragmatism” of the NHS England new care models director’s approach, others said they didn’t see “how such a Darwinian sort of system benefits anyone”.

Some were trying not to lose heart in the vanguard project, but weren’t finding it easy.

One reader said: “I’m trying not to be cynical about the vanguards as they offer great promise. But every time I read or see something about them it all seems to have descended into the usual… trite management buzzwords and people slapping themselves on the back, supported by national happy clappy encouragement.”

While another asked “How is temporary funding of a few pilot areas going to help with systemic pressures?”

But others were having no trouble being cynical: “Transformation, my eye. The cost savings are bobbins and take years of cultural change to get clinicians in the community to fundamentally change behaviours and develop different relationships. There’s no silver bullet, quick fix or big idea that will do this in one year.”