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‘This will come back to haunt them’

In what is a rare occurrence these days, HSJ revealed what appeared to be a bit of good-ish news about NHS finances on Monday.

Our analysis of acute trust’s finance reports covering quarter one of 2016-17 shows more than three-quarters of them are currently forecasting to meet their control totals set by NHS Improvement. The numbers effectively suggest only a small shortfall of £75m against the provider sector’s overall plan for a deficit of £580m (though regulators have said the deficit needs to be reduced further to £250m during the year).

The warm fuzzy feeling is likely to be temporary, unfortunately. Doubts have been raised about providers’ ability to meet the controls, and several trust sources have said they expect their position to worsen significantly over the year.

The finance director of one trust said “sustainibility and transformation” payments for performance in each quarter created a “financial incentive” for trusts to agree their control total and meet their targets early in the year.

They added: “It’s no surprise that quarter one looks okay. But in the next few months the underlying problems will start to surface, particularly in those trusts that were strong-armed to sign up to unachievable control totals. This will come back to haunt them.”

While Sally Gainsbury, senior policy analyst at the Nuffield Trust, warned: “Trusts have been incentivised to report that they’re on track to meet their target, to be over-optimistic about booking savings, or else forego the sustainability funds they need to pay their staff. So these figures are absolutely what I’d expect to see.

“People are now talking about a ‘big reveal’ around January 2017 when we could get a nasty surprise about the real deficit.”

See our full analysis, including interactive map, at hsj.co.uk:

Next phase for the vanguards

After the next financial year, vanguard sites will not have transformation funding allocated directly to them from NHS England.

The project in its initial form will cease at the end of 2017-18, and any future transformation funding will be allocated via sustainability and transformation plans – which will become the main instrument for implementing the Five Year Forward View.

The decision was confirmed in a document on the oversight and governance of new care models published this month by NHS Improvement.

Cap on track

The cap on agency rates for temporary staff in the NHS is expected to save up to £800m in its first year, according to NHS Improvement’s latest data.

The regulator also shared with HSJ incident data reported by trusts when they believe the cap has led to patient harm or service closure. The reports show two incidents of potential harm since the cap was introduced in November; 23 incidents with no harm; and 11 incidents of service closure.

An average of 214 trusts, or 90 per cent, breached the cap on the grounds of patient safety each week during quarter one of 2016-17.