HSJ’s digest of Wednesday’s most important stories

Not in the mood to negotiate

On Wednesday, the Department of Health stole a little bit of thunder from NHS England’s funding allocations announcement (due on Thursday), when it announced that £1.8bn of NHS England’s agreed funding increase for 2016-17 would go into a centrally managed “sustainability and transformation fund”.

This should not be confused with an actual transformation fund – the majority of the money is expected to be used to help providers (in particular, those of emergency care) to drag themselves out of deficit next year.

However, the central bodies were also keen to emphasise that this was not simply a handout. In a statement issued on Wednesday lunchtime, the DH said payments from the fund would be contingent on providers meeting a number of “strict and non-negotiable conditions” set out by NHS Improvement, NHS England, and the department.

These include agreeing to your “control total” bottom line for 2016-17, a “strong and measurable” financial recovery plan and a “credible plan for maintaining delivery of core standards” (ie: A&E and waiting times targets), as well as setting out a “clear and credible plan” for achieving seven day services by 2020.

Cynics might suggest that requiring people to agree plans is not the same as requiring them to deliver them. But we will see – the department also suggested that “sanctions will be included as part of the funding to ensure hospitals comply with the measures”.

A sixth CCG this year has been placed under legal directions by NHS England, due to its deteriorating finances, it was revealed on Wednesday.

Kernow CCG, in Cornwall, now needs to put together a financial recovery plan explaining how the organisation will be able to finish 2016-17 in balance and deal with its current £14m year-end deficit projection.

The commissioner will also need to bring in a turnaround director, under NHS England supervision.

Kernow’s experience is very similar to Shropshire CCG, which earlier this week become the first CCG to be placed in special measures – a slightly less serious form of regulatory intervention.

Shropshire’s regulatory requirements mirror those of Kernow – the need to put together a robust financial recovery plan and the recruitment of a turnaround director.

Meanwhile, East Surrey CCG has also recently been subject to intervention by NHS England, with legal directions being applied due to its financial problems.

Hopefully this doesn’t mark the start of a rash of CCGs needing support from the centre, especially as only 13 per cent of local commissioning leaders told our latest barometer they had good interactions with the NHS England national team.

The workforce isn’t with you

NHS providers should enhance pay for shortage specialities and offer flexible working hours to staff to tackle their rising spend on agency staff, HSJ’s Workforce Investigation  recommended on Wednesday.

The investigation, carried out with HCL, studied the underlying causes of the NHS’s escalating clinical temporary staff bill and had input from more than 70 chief executives, HR directors, medical and nurse directors and finance directors.