The must read stories and biggest talking points in the NHS

Budget busting

On Wednesday, chancellor Philip Hammond delivers his second budget of the year and the first since the general election, though – as Andy Cowper points out in this week’s column – it will have been finalised on Friday.

Hence the stories in the weekend papers about what might by in it – unfortunately it appears there’s to be no “NHS financial rescue remedy”.

There could be a pay rise for nurses, though HSJ editor Alastair McLellan has argued previously this isn’t the NHS’s priority, and some capital funding could appear.

“But it is clear that the fundamental issue will not be addressed, which is that the NHS has a not-particularly-well-hidden recurring underfunding problem relative to demand,” our columnist says. “We’re approaching a moment when a government that has been repeatedly and very publicly warned that the NHS funding situation will threaten quality, access and safety is going to choose to ignore that warning.”

We have more budget previewing with health charities leader Chris Askew setting out the three tests Mr Hammond needs to pass to “reverse the decline of access to timely and good quality healthcare”.

Meanwhile, we published another story on Monday showing the financial pressure facing the health service: Kingston Hospital FT has been relying on a working capital facility from Lloyds Bank to pay staff each month.

(Some) new care models success

Areas covered by new care model vanguards saw lower growth in emergency admission rates than the rest of England during 2016 and 2017, and a fall in the GP referral rate, analysis by HSJ indicates.

We looked at activity in 16 CCG group areas that, according to NHS England information, had a national vanguard site covering the majority of their population.

Comparing GP referrals in 2015-16 and 2016-17 per 100,000 population, the vanguard CCGs saw a 1 per cent decrease whilst non-vanguard CCGs had growth of 1.6 per cent.

On emergency admissions, the vanguard CCGs saw a 0.8 per cent increase. Across all other CCGs there was an increase of 1.9 per cent. However, the vanguard CCGs began with a substantially higher rate than the other CCGs.

A number of factors could be behind activity trends, but the finding appears to support NHS England’s claim that in aggregate vanguards are seeing slower activity growth than other areas. HSJ’s analysis also found some non-vanguard areas had seen greater reductions in emergency admissions, however.

While emergency admissions are seen as a key litmus test for success of whether new care models can moderate demand and costs; many of them have also focused on developing links between primary and secondary care which could reduce GP referrals, and building outpatient type services away from hospitals.