HSJ’s round up of Tuesday’s key stories

Today’s must know: Trusts rolling over 2014-15 tariff prices face massive deficits this year

Today’s talking point: NHS England instructs hospitals to complete 35 per cent of discharges before noon – and HSJ readers are unimpressed

Rollover tariff trusts expect more financial woe

The NHS provider sector - which finished last financial year £822m in the red - is facing further headaches over its cash this year. Five NHS trusts that rejected NHS England and Monitor’s “enhanced tariff option” expect to see their finances plummet by more than £30m year on year, according to figures obtained by HSJ.

Most of the 28 trusts that opted to roll over their 2014-15 prices have forecast deficits and significant deterioration in their financial positions for 2015-16.

Lancashire Teaching Hospitals Foundation Trust is facing the most dramatic swing. It has forecast a £47m end of year deficit, compared to a £1.6m deficit last year - a deterioration of £45.4m year on year.

Guy’s and St Thomas’ FT, Nottingham University Hospitals Trust, Imperial College Healthcare Trust and University Hospitals Birmingham FT also expected year on year declines of at least £30m.

The NHS Trust Development Authority said it is “still working with trusts to finalise their financial plans”, and stressed “there is not going to be a one size fits all solution to this”.

NHS England’s discharge own goal

“Management obsessing with targets and reporting instead of patient experience.”

“Yet another example of top-down micro-management by people who do not know how operations/front line work.”

“A poorly thought out target creating a perverse incentive!”

This is just some of the reaction from HSJ readers to a new NHS England directive for trusts to aim to carry out at least 35 per cent of discharges before midday.

It is one of eight “high impact interventions” developed by NHS England that it expects system resilience groups to adopt to improve urgent care.

However, an HSJ investigation found that trusts have been falling far short of this “best practice” recommendation (NHS England said it is not a “target”). Only 17.6 per cent of discharges were carried before 12pm on average throughout 2014-15, from the 88 acute trusts that responded to a freedom of information request.

One trust chief executive told us there were logistical factors that made it difficult to discharge patients before midday, such as prescribing and dispensing drugs, arranging transport and getting social care or community equipment needs in place.

HSJ senior correspondent David Williams also observed: