HSJ’s roundup of the day’s must read health policy stories

Stretching further down the back of sofa

When the Care Quality Commission increased its fees by 9 per cent last year, NHS Providers described the move as “difficult to justify” in the context of the financial pressure the NHS was under. That pressure has only increased since.

This looks like small change compared to the options for future hikes outlined by the CQC on Monday.

Fees paid by NHS trusts could be jacked up by between 40 and 75 per cent next year.

But the hardest hit providers are GPs – a single location practice could see its fees increase sevenfold by 2017-18.

The CQC said it has to charge more in line with a government policy for all regulators to fully recover their costs from the organisations they rule over.

That will be cold comfort for providers, with NHS Confederation chief executive Rob Webster among those warning the move could “jeopardise” support for the watchdog.

Winter is here

Hospital beds are full and the extra ones usually opened only during the winter months are already occupied, according to chief executives who are struggling with an increase in admissions usually seen later in the winter.

Acute trust chiefs are struggling to move patients out of beds and one trust estimates it has 50 patients every day who are fit for discharge but are stuck in the system.

One trust boss said it “already feels like winter” and another said the recent closure of three care homes near the hospital had meant more patients had nowhere to be transferred to once they no longer require hospital care. And it’s only the first week of November.

Three stories for the price of one

It’s official – clinical commissioning groups don’t seem to be in much of a hurry to formally procure their commissioning support services.

Currently in most of the country, support services are supplied to CCGs by commissioning support units under service level agreements. NHS England set up the lead provider framework at the beginning of 2015 to enable CCGs to undertake procurements compliant with EU law and choose between nine NHS and private suppliers.

There are three stories in one here.

First: NHS England has abandoned its timetable for CCG procurements. Originally this was to take place in four tranches during 2015. This never happened because…

Second: there is not much enthusiasm among CCGs for procuring commissioning support. While 35 CCGs didn’t have much choice but to use the framework after NHS England decided to kill off their CSUs, only 20 more are voluntarily using the lead provider framework to buy in the full range of support services. Three-quarters of CCGs, therefore, have not jumped yet.

Third: this is despite legal advice from NHS England strongly advising CCGs to reprocure by next April. NHS England has relaxed this deadline but in not going to market, are CCGs leaving themselves open to legal challenge?