The must read stories and talking points in the NHS

Doing the maths

Last week, Simon Stevens warned the NHS Providers conference: “On the current funding outlook, the NHS waiting list will rise to 5 million people by 2021… the government would have to publicly, legally abolish patients’ national waiting times guarantees.”

Waiting times expert Rob Findlay has calculated how much it would cost the government to get 18 week waits back on track. He says: “In short, the government has a choice: constrain the money and abandon the right to treatment within 18 weeks, or cough up and honour it.”

The abridged version is: “With some guesses about the costs per case, I calculate recovering 18 weeks sustainably might cost £2.1bn next year and £350m the year after, if other pressures and enough mainstream capacity are funded. Or £4.2bn next year and £1bn the year after, if austerity continues.”

Read his unrivalled analysis to see how he got to these figures.

Out of area, out of order

Trusts could face regulatory action for not reducing the time people spend being treated at mental health inpatient units miles away from home, HSJ revealed on Monday.

NHS Improvement has added out of area placements to its single oversight framework, which sets out the rules NHS trusts and foundation trusts are assessed under now that Monitor and the NHS Trust Development Authority have merged.

The change is part of the national drive to eliminate inappropriate out of area placements by 2020-21, set out in the Five Year Forward View for Mental Health implementation plan.

Out of area placements are when mental health patients are sent to inpatient units outside their local area for treatment – sometimes hundreds of miles away from home.

The new performance metric is part of a joint programme between NHS England and NHSI to get providers to reduce out of area beds days each quarter.

The updated guidance said providers will be expected to meet a trajectory to eliminate out of area placements by 2020-21 agreed with NHS England and NHSI’s regional teams between October and December.

Under the single oversight framework, providers are placed into one of four bands based on their performance against different care quality, financial and operational performance criteria.

Those in the lower two bands with significant or major concerns that have breached, or are suspected of breaching, their licences will be given mandated support from NHSI.

This means mental health providers could face mandated support from the regulator if they fail to meet their out of area bed days improvement trajectory.