The must read stories and debate in the NHS

A never ending story

The quarterly update on NHS trust finances told a familiar story – that despite providers continuing to deliver cost savings of more than 3 per cent, the deficit is not going away.

Worryingly for NHS Improvement, it’s now showing signs of getting worse despite the extra cash chucked in by the government in the Budget.

According to official figures published by NHSI, providers’ combined deficit is now forecast to grow to £930m by the end of 2017-18.

This would be almost double the £496m planned at the start of the year, and means the forecast has worsened by £300m over the last three months.

As HSJ revealed earlier this week, the deterioration has been largely driven by trusts with heavily backloaded savings’ plans.

The figures will pose further questions about the NHS’s ability to balance its books on the funding available, and could trigger a further clamp down from the Treasury.

Although part of the deterioration is due to expected pay bill savings failing to materialise, NHSI’s report suggests progress is being made on reducing vacancies and cutting the wage bill.

Published for the first time, consolidated figures on NHS vacancies suggest more than 8 per cent of posts are currently unfilled, including one in 10 nursing roles, but that there had been a reduction in vacant posts over the last three months.

The report said: “The vacancy reduction observed since quarter two is an outcome of expected substantive recruitment from month six. There has also been a notable reduction in agency staffing over to bank with the ambition to see this consequently move to a more sustainable substantive staffing model in the future.”

Court in the middle

Public health contracts don’t always attract controversy, but a case in Lancashire is certainly getting people riled up.

Two NHS trusts have warned that missing out on a £100m, five year contract for school nursing and health visiting in the county will result in the loss of 160 jobs and up to £2m in funding – and it would threaten other services.

It follows Lancashire County Council’s choice of Virgin Care as its preferred provider.

The decision will likely have been a shock to Lancashire Care and Blackpool Teaching Hospitals trusts, the incumbent providers, given national leaders’ keenness for closer collaboration between the NHS and local authorities.

The trusts claim the council failed to apply the scoring criteria correctly, and other errors and deficiencies occurred during the bid evaluation process.

The trusts’ challenge forced a suspension of the contract award to Virgin, which the council subsequently applied to remove at a hearing last month.

But, according to a recently published summary of the hearing, the judge ruled lifting the suspension would undermine the trusts’ ability to provide other services.

Mr Justice Fraser cited an example given by one of the trusts that “lifting the automatic suspension would also result in the loss of senior staff who currently manage the full range of children’s services provided across all contracts”.

The case is now likely to go to trial in the spring, when the court will determine whether the council’s procurement was compliant with the rules.

Both trusts will continue to provide the services in the interim.