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England’s first batch of NHS trusts hoping to rebuild their hospitals have been told to submit plans with a cheaper price tag.

The order, from the government’s New Hospital Programme leadership team, also requires the eight trusts to send their preferred plans and – additionally – a “phased approach” to delivery of their preferred plan. 

What should we read into this?

Given that the eight trusts were selected as “pathfinders” back in 2019 based partly on the maturity of their plans, the government must already have a good idea of each trust’s preferred option.

But the problem is that most of these plans come with a large price tag, ranging from £500m to £600m.

As the NHP’s letter to trusts said, the 40 hospitals must be delivered within a “finite and carefully controlled budget envelope”.

It seems some alarm bells have been ringing across Whitehall over the total cost of all the trusts’ preferred options.

Chiefs therefore want to see credible options for cheaper hospitals, in order to work out which schemes will justifiably cost more and – therefore – which schemes must offset those extra costs.

But this has – inevitably – raised fears at trust level about once-in-a-generation plans needing to be watered down.

Much will depend on the success of the DHSC’s commercial strategy which – hopefully – will drive down construction and bureaucratic costs. Failure to do this will put further constraints on funding the trusts’ preferred plans and having to settle for cheaper options.

Taking shape

We now know who 25 of the 42 chairs are of the NHS integrated care board chairs that will plan health services from April. 

Of those so far selected (see our story for the full list), 11 are women (26 per cent of the final total), and five have a minority ethnic background.

Job adverts have been published for the remaining 17 posts, with a salary range of £55,000-£80,000.

ICBs will take on the commissioning functions of clinical commissioning groups in April. They will also be given some of NHS England’s responsibilities over the next two years.

NHS England has approved the movement of 60 per cent of the current integrated care system chairs into the new roles. ICSs are due to be put on a statutory footing by the government’s Health and Care Bill from the start of the next NHS financial year. The ICBs will lead the new organisations.

ICBs will work with local authorities to create an “integrated care partnership” board for each system. This ‘advisory’ board will develop the area’s health and care strategy. A process for selecting ICS chief executives is expected to begin in the coming weeks.