HSJ’s round-up of Thursday’s essential health stories and debate

HMT tightens its grip

The Treasury’s grip on NHS finances is becoming ever more apparent.

Since the start of 2016 we have seen HMT demand signoff on £800m worth of clinical commissioning group budgets, as well as payments to providers from the £1.8bn sustainability fund.

And now the squeeze looks to be tightening on providers’ capital budgets, with local leaders told to scale back their spending plans for the year.

In a presentation document from an NHS Improvement event last week, seen by HSJ, trusts were warned that “pressure [is] increasing for capital controls, with HMT direction possible because of the current forecast – finance directors to review assumptions urgently”.

It adds: “Potential for investment decisions to require NHSI/DH/HMT approval over de-minimis values.”

There is of course a growing backlog of maintenance problems on NHS estates, while many of the 44 regions drawing up sustainability and transformation plans are likely to put forward a case for significant capital investment in order to transform services.

The document suggests NHSI and the Department of Health have been making this argument to HMT, with the subject said to be “under discussion”. The response will likely depend on how the new prime minister and chancellor view the NHS financial crisis – a subject they haven’t yet broached publicly.

Alarm at ambulance trust rating

South East Coast Ambulance Service is to be placed in special measures after inspectors rated it inadequate and identified concerns related to its leadership, culture and ability to ensure patient safety.

The Care Quality Commission rated the trust inadequate overall, and the trust was also given the lowest rating for its emergency and urgent care services, safety and leadership.

Chief inspector of hospitals Professor Sir Mike Richards said the trust had been through a period of “significant upheaval” following changes in its senior leadership.

Capital coming together

Five CCGs in north central London are considering a move to a single chief officer across their STP footprint, HSJ understands.

Several sources said a proposal to share a single accountable officer was being put to the CCG governing bodies which make up North Central London STP.

The five CCGs are: Barnet; Camden; Enfield; Haringey; and Islington.