Your essential update on the week in health

HSJ Catch Up

This 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.

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STPs will ‘end purchaser/provider split’

Simon Stevens has previously danced around the policy wonk Nirvana concept of abolishing the purchaser/provider split.

Keen to keep it vague, the NHS England chief executive has previously garbled: “I do think there’s real value in distinguishing the planning and funding functions from the provision. But does it for all time have to be the split that we currently have and the way we work it? No, there are various models.”

Pressed to explain how he is going to make sustainability and transformation plans work, in front of the Commons public accounts committee on Monday, Stevens went further: “We are going to for probably between six and 10 [STPs] actually get them going as accountable care organisations or systems, which will for the first time since 1990 effectively end the purchaser provider split, bringing about integrated funding and delivery for a given geographical population. So this is pretty big stuff and actually people are pretty enthusiastic about it.”

Smith and Mackey confirm exit plans

In an announcement revealing that chair Ed Smith is retiring this year, NHS Improvement also confirmed that Jim Mackey will stand down as chief executive in October as originally planned. He is on a two year secondment from Northumbria Healthcare FT.

Mr Smith’s departure will be a year earlier than expected, however, “to allow a new chair to be appointed in time to lead the search for a successor chief executive”. He had been due to stay in the role until July 2018.

The trusts posing biggest risks to financial plan

Analysis by HSJ shows which providers must deliver the largest savings in the final three months of 2016-17, and which therefore present most risk to the sector’s year-end position.

As reported last week, figures published by NHS Improvement have forecast a provider sector year-end deficit of £873m, against the maximum control total of a £580m deficit.

However, the actual run rates in the first nine months of the year suggest that a major improvement must be delivered in the final quarter to hit this forecast.

If the average performance in the first nine months is projected across the whole year, the sector would report a deficit of £1.14bn. Around 80 out of 237 trusts were behind the average run rate required to meet their forecasts after the first nine months of 2016-17.

We also revealed that 40 NHS trusts set to miss their financial targets have received almost £200m from the national STF intended to reward trusts for good performance.

What to expect from the Forward View delivery plan

At the end of month, the NHS will turn its attention to the new Five Year Forward View “delivery plan” – trailed in an HSJ interview with Simon Stevens last year.

In his latest expert briefing, Dave West looks at what to expect from the plan.

He says: “Forward View Mark 1 was warmly welcomed by every interest group worth their salt, signed by the full set of NHS quangos, and showered with praise across the political divide.

“The delivery plan might have a bumpier ride. We’ve seen two more years of performance decline, the finances are on a precipice, and Simon Stevens has been dipping into his political capital (not to mention the actual capital).”

Mackey tightens measures for locums

It’s long been known in the service that agency nurses were an easier target for reducing costs than agency doctors – now we’ve seen official recognition.

HSJ broke the news that a new raft of measures was being introduced, aiming to force doctors holding an NHS contract but working for another trust to do so on a bank rather than agency basis.

That and the HMRC rule change on staff being paid as small companies to avoid tax could make a difference in the medium term, but in the short term will create an administrative headache for trusts.

Kirkup to lead new investigation

After three years of delays, wrangling and “regulatory gaps”, the family of Elizabeth Dixon, who died in 2001, have finally moved a step closer to justice for their daughter.

Health secretary Jeremy Hunt has appointed Dr Bill Kirkup, chair of the Morecambe Bay inquiry, to lead the investigation, which has been stalled after NHS England pulled the plug on a joint inquiry with the Care Quality Commission in 2014.

The CQC were unable to look into the case and the PHSO also ducked it – leaving the family without any organisation willing to step up until the health secretary intervened.

Financial gap deepens for Northumberland CCG

Northumberland CCG – which is rated “inadequate” and is under legal directions from the regulator – has officially been forecasting a £5m deficit for 2016-17, but board papers this month reveal the financial gap has spiralled to the point where it is expecting to end the year with a £41m deficit.

But, more controversially, governing body papers also reveal NHS England had asked the CCG to continue reporting its deficit as £5m instead of the full £41m.

A spokesman told HSJ that NHS England had to have a clear understanding of why a CCG’s financial position was deteriorating and what action is being taken before a “budget movement is ‘baked in’ to a valid forecast”.