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Honest conversations

Local commissioners must deliver efficiency savings of almost 4 per cent to meet their financial targets this year, despite failing to get close to last year’s target of 3.2 per cent.

HSJ also understands around 20 clinical commissioning groups have been asked to resubmit their plans with a “more challenging” savings target. If they do so, this would push the average savings requirement higher.

The financial plans for CCGs, which are based on their funding allocations and have now been assured by NHS England, demand average efficiency savings of 3.8 per cent in 2017-18, according to NHS England’s finance report for July.

In 2016-17, CCGs had to plan for savings of 3.2 per cent but only achieved 2.6 per cent.

Julie Wood, chief executive of NHS Clinical Commissioners, said the funding allocations and targets mean local leaders are having to make “really difficult, bordering on impossible, choices”.

She added: “Recent NHSCC analysis highlighted how rising inflation, along with a growing population, means that while on paper the funds allocated to CCGs are going up, in reality the value of the CCG pound is shrinking.

“Far more CCGs are in deficit or have deficit control totals. Their quality, innovation, productivity and prevention programme [efficiency] targets are getting higher and for many they don’t have formal plans for how they will deliver all of what is needed.

“Previous QIPP targets were lower but still the commissioning sector struggled to deliver them fully, so confidence to deliver these higher levels is low.”

Meanwhile, the new chair of the Academy of Medical Royal Colleges, Professor Carrie MacEwen has called for an “honest conversation” about what the NHS can afford to provide.

In an exclusive HSJ interview, she said: “Looking at the manifestos for the general election, there wasn’t a party that didn’t say they weren’t going to put money into the health service. The question is, is it enough?

“We feel there should be clarification around what is needed and… there needs to be an honest conversation with the public if it is recognised that what needs to be funded can’t be funded adequately.”

She added: “The public expectation currently is extremely high and the question is can we meet that expectation or can we not? I think we need to have that conversation with the public to say what we can’t offer them.”