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

The finance directors hit back

A toughly worded ultimatum from regulators over financial plans for next year has received a predictably spiky response from trust finance chiefs.

One in three providers have rejected their nationally dictated “control totals” for 2016-17, so the big question now is whether Monitor and the NHS Trust Development Authority will dare to withdraw their offer of “sustainability and transformation” funding.

Derby Teaching Hospitals Foundation Trust appears to be among those sticking two fingers up to the regulators, after being offered £13.6m of sustainability and transformation funding, so long as it agreed a deficit plan of £11.3m next year.

But the FT, which had previously set a draft deficit plan of £31.4m for 2016-17, has simply deducted the STF from this, and has sent Monitor a new draft £17.8m deficit plan. In effect, the trust appears to be assuming it will receive the funding anyway.

Meanwhile, many of the trusts that accepted the offer have only done so with conditions and caveats, leaving a mammoth job for the regulators to assess all the responses.

This is exactly what they didn’t want, but probably what they expected.

DTOCs improvement can’t happen quick enough

Delayed transfers are rising too fast in too many areas and have too big an impact on hospital capacity to be ignored.

Ministers have been worried about DTOCs for at least a year now, and last month NHS and council leaders were directed to come up with plans to really sort it out this time, once and for all, via the better care fund.

It was already a key better care fund metric because it’s one of the few viable proxy indicators we currently have for how well integrated a system is. So in 2015-16 every area has already been required to ensure discharge support is in place, and has been filing quarterly reports detailing how delayed transfers have been steadily rising all year regardless.

This decline in performance is mapped and tracked in an extensive HSJ analysis of the delayed transfers problem. We’ve worked out the rate of delayed days per 100,000 population per year for every health and wellbeing board.

This enables us to identify the best and worst performers, who has improved the most over the past year and who hasn’t, and how everyone compares to the national average. All this information is contained in an interactive map, and explained in our long read analysis on the subject, which even highlights some areas of good practice and identifies some of the things they have in common.

Hopefully in a year’s time we’ll have a new load of data and graphics illustrating how best practice has been widely adopted, and that as a result delayed transfers are rapidly becoming a thing of the past.