Your essential update on the week in health

HSJ Catch Up

This new weekly email gives HSJ subscribers a vital update on the biggest stories from the last week in health. If you have been out of the office or otherwise just too busy to keep up, HSJ Catch Up will ensure you are still in the know.

Trusts to face tighter bailout controls

In recent weeks the difficulty the NHS is having on containing revenue spending has been well documented by HSJ, but we’re now seeing signs that the service is fighting off a full blown cashflow crisis.

A leaked email from NHS Improvement says NHS trusts will face tighter controls when requesting cash bailouts to ensure staff and bills can be paid.

From now on, when trusts ask for a bailout they will be subject to an increased level of challenge scrutiny from the Treasury and the Department of Health. As part of this, providers will have to detail where suppliers have threatened to put their account “on stop”.

Trusts’ reliance on bailouts has been growing in recent years as expenditure has grown faster than income.

Chancellor reinforces government’s stance

The NHS and its interested parties seem to be hitting a wall with their protestations over the government’s funding claims.

There is no doubt the “extra £10bn” claim is misleading, but however rational the argument, the new administration has taken its position and ain’t gonna budge.

Chancellor Philip Hammond has reinforced the government’s argument in a letter to the Commons health committee.

In last year’s spending review, the government redefined the ringfence around “NHS spending” to only include the NHS England budget, which left the door open for cuts to other health budgets.

Looking back at the 2015 Conservative manifesto, it appears to have been carefully worded with this in mind.

Meanwhile, an NHS England report that set out the financial gap cited in the Five Year Forward View assumed the “health budget will remain protected in real terms”.

No matter how you define the ringfence, successful delivery of the forward view was always predicated on social care being protected and prevention services being upgraded.

Simon Stevens will no doubt be tempted to keep reiterating this point, but will be conscious that the new regime may quickly grow tired of these protests.

Mackey targets capital and PFI

The squeeze on NHS capital funding has been well documented, with sustainability and transformation plan leaders being told not to hold their breath over their requests for capital investment.

The Department of Health’s capital budget has been frozen in cash terms over the course of this parliament, and it has also been repeatedly raided in recent years to prop up the revenue account. Another £1.2bn transfer is expected in 2016-17, making the situation even tighter.

Jim Mackey, chief executive of NHSI, told the HSJ Summit the regulator is seeking greater flexibility around capital spending and is looking to create an “NHSI bond”.

Last month HSJ revealed a huge spike in backlog maintenance problems at NHS trusts, which are struggling to access capital funds to deal with the issues.

Mr Mackey also revealed NHSI has established a working group looking at the possibility of buying out some providers’ PFI schemes.

Trust launches legal challenge to contract loss

A struggling foundation trust is taking its fight to retain a £30m community services contract to the High Court after losing out to a rival bidder.

Disgruntled Humber Foundation Trust has asked the court to halt East Riding of Yorkshire CCG’s procurement process and investigate the criteria used to award the five-year contract.

The FT is the CCG’s current provider of community services and will continue to be until the High Court makes its decision.

But if that decision goes against the trust it will be another blow following the CQC rating it as “inadequate” for safety in August.

Inquiry on non-clinical staff published

The “second-class citizen status” of NHS staff who do not have clinical roles must be addressed urgently, an HSJ inquiry has concluded.

The HSJ / Serco Inquiry on Maximising the Contribution of NHS Non-Clinical Staff said that the work undertaken by more than half a million NHS workers is too often hidden, leading to a “divisive” hierarchy which has a negative impact on both the service and the patients it treats.

The inquiry, published on Monday, concludes that the work of those in areas such as IT, facilities and estates should be championed at board level by non-executive directors, while HR departments and unions also have a role to play in making sure their voice is heard more loudly within the NHS.

Long waiters continue to rise

A London teaching hospital has more than 100 patients waiting over a year for treatment.

Imperial College Healthcare Trust has 102 patients whose waiting time has breached the 52 week target for treatment, its latest board papers reveal.

The trust reported a 47 year-plus waiters in March, while in July, board papers said the total had hit 80.