The must read stories and debate in the NHS
- Today’s must know: NHS in ‘Mexican standoff’ with locums due to new tax rules
- Today’s talking point: STPs to be told how to make integrated care savings
- Today’s risk: Staffordshire still unsustainable after ‘failed’ Mid Staffs dissolution
STPs are to be given tailored guidance on how to integrate physical and mental health services and what savings they can make.
The bespoke data packs for each of the 44 STP regions have been commissioned by NHS England and are due to be sent out at the end of April.
Produced by Midlands and Lancashire CSU, the packs will set out how each STP can improve patient care and also model any financial savings that can be made.
The £150,000 project will provide data and analysis to support STPs and commissioners to develop investment cases for key priorities recommended by the Mental Health Taskforce.
Integrating physical and mental health is a key plank of the NHS England’s implementation plans for the Five Year Forward View for Mental Health.
The plans include making savings across the country by 2020-21 through introducing new services such as liaison psychiatry, integrating psychological therapies into physical healthcare services and reducing pressure on A&Es.
The key question is what additional insight the data packs are going to provide STPs, given that NHS England has set out national saving estimates and STPs have been running financial models of their own.
If the bespoke reports offer STPs genuine insight into how their local systems can improve integration and make savings then it will be money well spent. If not, then it will simply be the centre preaching to the choir.
Taxing new rules
The NHS is in a “Mexican standoff” with locum doctors, agency nurses and private contractors, with some threatening not to work when new tax rules come into force this week.
HSJ has learned some locum doctors are demanding uplifts of more than 50 per cent in their pay as NHS trusts take on responsibility for paying their tax and national insurance from Thursday, under new IR35 regulations from HMRC.
The regulations apply to any temporary staff being paid through a personal service company and could reduce income for temporary staff by more than 20 per cent.
In one example of the problems facing the NHS, IT contractors walked away from working on a multimillion pound project at Guy’s and St Thomas’ FT rather than accept the new rules.
At other trusts, substantive staff are being asked to work extra shifts. Trusts have cancelled non-mandatory training time, consultant supporting professional activities time and have suspended secondments so staff can work on wards. Some have even prepared processes used during last year’s junior doctors’ strike to respond to any significant staffing shortfalls.
One NHS finance director told HSJ: “[The situation] is akin to a Mexican standoff. Some locums have been asking for between 30 and 50 per cent price uplifts. More than likely we will have to pay this; it is a Hobson’s choice.”