The must-read stories and debate in health policy and leadership

Get off the pot

The great and the good of the NHS have been making their case to the government, and more specifically the prime minister, about the need for a decent funding settlement and stability for the NHS.

NHS Confederation boss Niall Dickson told HSJ that predictable funding over a long period would pay dividends and that the year-by-year settlements had looked like the Himalayas when plotted on a graph.

He said anything less than a 4 per cent real terms rise would enforce a “managed decline”.

The national media have all trailed that there is something coming but not when, or how much. Sources spoken to by HSJ expect the true number maybe somewhere between 3 and 4 per cent.

Meanwhile, the people actually planning the delivery of services for the rest of 2018-19 are left wondering what to do. Is the provider sector aiming for break-even as previously stated, or will it be allowed to go for something more realistic?

NHS Improvement boss Ian Dalton told delegates at the Confederation’s conference in Manchester that the plans were not yet ready and that discussions were ongoing with a number of trusts.

One of these trusts will probably be King’s College Hospital Foundation Trust, which HSJ last week reported had gone to the regulator with a deficit offer of £156m, a signficant slippage on 2017-18’s £132m deficit.

All change in provider land?

Mr Dalton also promised a “long, hard and important look” at clincial services and provider organisations that house them.

Mega-chains? Another spate of mergers? The Getting It Right First Time programme given more power?

The language was a little vague but matches up with earlier comments about taking a firmer approach to reconfiguration - an agenda that has languished in the face of ever-increasing activity and the focus on governance that can accompany sustainability and transformation partnerships.

This was a point picked up by NHS England deputy chief executive Matthew Swindells in his speech to delegates, where he warned managers not to get too hung up on organisational form. He said in some areas integration at borough level was paying dividends.