Three strikes

Junior doctors could carry out three days of strike action next month including two days without cover for urgent or emergency care.

The British Medical Association council approved the possible dates for industrial action on Thursday, ahead of the results of a ballot of junior doctor members later this month.

The proposed dates for industrial action are:

  • 8am Tuesday 1 December to 8am Wednesday 2 December – emergency care only.
  • 8am to 5pm, Tuesday 8 December – full walkout.
  • 8am to 5pm, Wednesday 16 December – full walkout.

With strike action a very real possibiliy next month, HSJ’s workforce correspondent Shaun Lintern explains what could happen after the walkout, and who can be peacemakers between the BMA and government.

Make do and mend

HSJ has written many stories in recent months about the Department of Health raiding NHS capital funds to pay for ongoing cost pressures.

Admittedly, these stories can seem a bit dry and remote (except to finance officers, who find them thrilling), but on Thursday we published a reminder as to why they matter.

According to trust estates data submitted to the Health and Social Care Information Centre, NHS providers now face costs of more than £450m to deal with a backlog of “high risk” maintenance problems, an increase of almost 30 per cent on the previous year.

This covers repairs or replacements that must be addressed urgently to “prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution”.

Capital investment to deal with backlog maintenance reduced by 6 per cent last financial year, and 12 per cent the year before.

One estates director told us: “Most [trusts] are pulling back on capital investment and being much more selective. This means there’s more of a make do and mend approach to maintenance when the right and more cost effective way of doing things is to fix things properly in the first instance.”

He fears hospitals will increasingly suffer fires and power outages due to ageing electrical plants, while old boiler systems will continue to rack up heating costs.

So pay close attention to those capital to revenue transfers. As the experts warn, they have long term consequences.

Be prepared

It’s not only providers feeling the pinch.

Clinical commissioning groups across the Midlands and East have been asked to plan for further reductions in their administration budgets.

HSJ has learned that the 61 CCGs have been told by NHS England’s regional team to plan for 5 per cent “year on year” reductions in their running cost allocations.

The body has told local CCGs to submit a draft financial plan covering the financial years 2016-17, 2017-18, and 2018-19, based on a number of planning assumptions, including the running cost reduction.

The region’s CCGs have also been asked to plan for lower revenue growth, according to documents presented to Coventry and Rugby CCG’s governing body meeting this week.

Spending on running NHS commissioning organisations has already seen cuts in recent years. CCG running cost allowances were reduced by 10 per cent in 2015-16 compared with the previous year, in line with the government’s requirement that the Department of Health administration budget be cut by 10 per cent.

An NHS England spokeswoman said that the advice from the regional body was not official guidance, but based on local planning assumptions.