HSJ’s roundup of Thursday’s key stories and talking points

Redefining the ringfence

Readers worrying about how the NHS was going to survive until 2021 with just £8bn in real terms funding growth will be pleased to learn the reality could be very much worse than that.

Well placed national figures have told HSJ the Treasury may redefine the ringfence on NHS spending to apply only to NHS England’s commissioning budget. This will leave billions spent on public health, training, and research unprotected in the coming comprehensive spending review.

Senior figures at the Nuffield Trust and the King’s Fund said they have been given direct indications by government officials that the Treasury was defining protected NHS spending as including only NHS England’s £101bn budget for commissioning health services.

This would mean huge budgets such as Health Education England’s £4.9bn and Public Health England’s £3.7bn were not protected by the government commitment to increase NHS spending in real terms by 2021.

Nuffield Trust chief executive Nigel Edwards told HSJ: “Our concern is that the way they have carefully described the ringfence allows them to take large amounts of money out of training, public health, and research and development without breaching their promise on spending on the NHS – except that large amounts of the money from those three budgets goes back into NHS care.”

A tough gig

Tim Kelsey’s departure from NHS England, exclusively revealed by HSJ on Thursday, leaves someone with a very tough assignment in filling his shoes.  

The body’s national director for patients and information has doubtless made some high profile mistakes – the Care.data fiasco still grinds on – during an eventful three years. But to focus on these would be underestimate the contribution Mr Kelsey has made in propelling the need to drag the NHS into the digital age into the mainstream

The NHS has long struggled with the implementation of technology and spearheading this process will remain a highly challenging role fraught with practical, cultural and political difficulties

Mr Kelsey became an influential figure in the Whitehall corridors of power after a stint as the Cabinet Office’s transparency tsar. He quickly acquired the ear of health secretary Jeremy Hunt and the “paperless NHS by 2018 ambition” was born in January 2013.

The “ambition” was never likely to be achieved, and has been pushed back to 2020. But Mr Hunt’s assertion that technology was a top priority and Mr Kelsey’s relentless drive have ensured a credible - if highly ambitious and taxing - plan has been formulated in the shape of Personalised Health and Care 2020.

The three main bodies responsible for the NHS digital project - NHS England, the DH and the Health and Social Care Information Centre - must now ensure the agenda does not become a hot potato thrown between the different organisations.

Responding to the news, however, many HSJ readers were more concerned about what Mr Kelsey’s departure to Australian firm Telstra Health means for his band Betting On Trains.