HSJ’s round-up of Wednesday’s must read stories

Mission impossible

More than a quarter of NHS trusts have rejected their financial targets for 2016-17, and it’s no wonder once you consider the efficiency assumptions that are built into them.

Analysis by NHS Providers suggests these 60 or so trusts were tasked with delivering average cost improvement programmes of 6.4 per cent, which is more than three times higher than the rate Lord Carter and Monitor thought was possible.

In an NHS Providers’ survey, trusts described their savings requirements as “impossible” and “undeliverable”, and that it would be “irresponsible” for the board to sign up to them.

Of the respondents, there were four trusts that had to reject CIPs of around 10 per cent.

The stated aim of national NHS bodies has been for the provider sector to post a deficit of £250m in the current financial year, and then to break even in 2017-18.

But this year’s deficit will be far larger than was hoped, with the latest official forecast suggesting a £873m overspend.

So the failure to deliver the impossible this year has led to more impossible targets next year. Welcome to the world of NHS finance.

Meanwhile, you also have to worry about some of the trusts which did accept their control totals, and will now have to deliver CIPs of 6-8 per cent. Do they really believe in these plans?

Triple trouble

Three more trusts have been placed in financial special measures by NHS Improvement, while some of the worst performers against the headline “control totals” avoided the regime.

St George’s University Hospitals Foundation Trust, Northern Lincolnshire and Goole FT, and University Hospitals of North Midlands Trust have all reported major deteriorations over the last few months, and will now have improvement directors sent in by NHSI.

The regulator had previously said it was discussing the potential for special measures with 12 trusts, so there are nine others who perhaps came up with a more convincing case for ploughing on by themselves.

NHSI said it considers a range of factors when making a decision over special measures, including any “exceptional mitigating circumstances”, any existing regulatory action or support, whether the existing management requires additional support, and the recent track record of financial recovery.

Trusts such as King’s College Hospital FT, Royal Free London FT and Hinchingbrooke Health Care Trust might count themselves lucky – judging by their headline performances at quarter three.

Chief inspector wanted

We now have a good idea of what the CQC is looking for in its next chief inspector of hospitals.

Professor Sir Mike Richards will retire this summer, and the regulator has released an advert and job description for his successor.

The CQC is looking for a “a highly influential figure” with the “political acumen and professional standing to be credible with the secretary of state, clinical professionals and the public”. The ad said that Sir Mike’s replacement will be “a clinician or board executive with significant experience of the NHS”, but regulation experience is “desirable but not essential”.

The successful applicant will be tasked with delivering the regulator’s “new flexible intelligence driven inspection model that can accommodate new models of care”.

And all for between £161,000 a £191,000 a year.