The must read stories in health policy

HSJ would like to apologise to subscribers who did not receive Wednesday morning’s Daily Insight. This was due to technical problems that have now been resolved.

Dismantling what’s left of the FT/non-FT divide

Some significant proposals in NHS Improvement’s new performance measure proposals.

The regulator’s view of the world can be clearly discerned from the things it is considering making part of the formal assessment system for trusts: agency staff, the new efficiency metric from the Carter review and more.

The significance of the former can be gauged from the fact that agency spend is also being considered as part of an assessment of a trust’s governance, not just how it’s doing on finance.

This is maybe overkill considering the market forces that govern agency spending are largely out of boards’ control. There can’t be many chief executives out there who are lackadaisical about it. Indeed, HSJ has been told about trusts referring agencies to counter-fraud services. So there’s already plenty happening on this front.

This is also the first ink on paper we’ve seen about promises to lower the regulatory burden on the top performers, while increasing it for those at the bottom of the table.

The prize of becoming a foundation trust used to be less reporting and greater independence. Now it is just looking like less reporting.

Because that is another implicit-ry of this joint system for FTs and non-FTs – it now doesn’t matter if you’re an FT or not.

Arguably, it hasn’t for a while, but it’s more official now.

However, the law underneath remains the same, and FTs still have governors. Governors who could potentially thwart some of the large-scale reconfigurations the centre is leaning on people to make happen (see below).

Three is the magic number

NHS trusts have been given a month to produce plans for merging back-office and pathology services with their neighbours, as part of a three-pronged plan to bear down on this year’s provider sector deficit.

Leaders in each of England’s 44 sustainability and transformation plan patches will also be given until the end of July to identify any planned care services in their area that are heavily dependent on locum staff and could be merged or transferred to other providers.

The news came in a letter from NHS Improvement sent to every trust chief executive in England on Tuesday afternoon.

The letter, from NHS Improvement chief executive Jim Mackey and chair Ed Smith, confirmed that the provider sector is on course for a deficit of £550m this year. It warned that this level of deficit makes “management of the overall NHS financial position very risky”.

It says NHS Improvement is aiming to get the provider sector deficit down to £250m this year through a combination of three measures:

  • bearing down on paybill growth in selected providers;
  • large-scale back office consolidations; and
  • the merger or transfer of “unsustainable” elective services.

However, Mr Mackey has dismissed rumours that NHS Improvement might “tear up control totals” and issue trusts with even more demanding financial targets. He told an HSJ/Capsticks roundtable that if someone had “[shaken] hands on a control total” he was going to abide by the agreement.

Mary Seacole honoured

On Thursday, a statue of pioneering black nurse Mary Seacole will be unveiled at St Thomas’ Hospital in London.

Former trust chief executive Lisa Rodrigues writes on our website why, following the EU referendum, this tribute is more important than ever.