Your essential update on health for the week

 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.

If someone forwarded you this email you can sign up for your own copy here.

Official estimate of growing waiting list and patients’ backlog

The recent downgrading of the elective care target by NHS England led to lots of warnings about a growing waiting list and backlog of patients breaching the national 18 week standard.

And a document obtained by HSJ provides an official estimate of the deterioration, assuming no action is taken.

It sets out a “do nothing” scenario in which performance against elective care targets deteriorates significantly over the next two years.

It suggests the backlog of patients waiting more than 18 weeks would grow from around 370,000 in February 2017 to almost 800,000 by March 2019, while the overall waiting list would grow from around 4 million to almost 5.5 million.

The story was picked up on the front page of The Times, and in most national newspapers.

NHS investment funds will continue to be raided

The Department of Health has confirmed that NHS investment funds will continue to be raided for the next three years to prop up day to day revenue budgets.

In a letter to the Commons health committee last month, minister Philip Dunne said the DH is planning to cease transferring money from capital budgets by the end of 2019-20, with the size of the transfers being reduced each year.

In December, HSJ reported figures used by national NHS leaders in a presentation document, which said £1bn would be transferred this year, followed by £500m in 2018-19 and £250m in 2019-20. However, the DH would not confirm these figures at the time.

The capital budget has been repeatedly raided in recent years to balance growing revenue deficits in the NHS trust sector, with £1.2bn transferred in 2016-17 and £950m the previous year.

Job cuts at HEE

More than 300 posts are set to be cut by Health Education England as part of a drive that could save over £10m in pay costs alone, HSJ has learned.

Documents seen by HSJ show the national education and training body is planning to remove at least 315 full time equivalent posts from its core workforce as part of a restructuring plan.

The proposed cuts follow the 2015 autumn statement, when arm’s length bodies – including HEE – were excluded from the ringfenced health budget after it was redesigned by chancellor George Osborne, to encompass only NHS England’s commissioning budget.

Professor Ian Cumming, chief executive of HEE, said: “As we made clear in public at our board meeting in March, we are required to reduce our overall running costs by 30 per cent and to reduce the money spent on running our education support by 30 per cent by 2020. This is not about training places or the quality of training but about making changes to our organisational structure and reducing administration costs to ensure we divert all possible resources to the front line and patient care. Similar reductions have been applied to the Department of Health and its other arm’s length bodies.”

Royal Free meets its target after selling hospital site

HSJ is currently in the process of collecting NHS providers’ reported financial performance figures for 2016-17, and has come across a number of large one off transactions that have helped trusts get over the line, in terms of meeting their year end control totals.

The biggest recovery is likely to be the Royal Free London Foundation Trust, which has met its surplus target after selling one of its hospital sites to its charity arm for £50m.

The deal has certainly raised a few eyebrows – especially as it enabled the trust to receive an extra STF payment – but has apparently been cleared by NHS Improvement and the Charity Commission, and appears to fit in with the charity’s strategy to provide key worker housing.

Without the deal the trust was heading for a deficit in excess of £40m, so it will now have to focus on delivering real operational efficiencies to get back into balance.

Slow going in special measures

Fewer than one in five trusts placed in special measures because of inadequate care have improved quickly enough to be removed within 12 months, as originally intended, HSJ’s latest analysis reveals.

We looked at the 27 trusts which have been placed in quality special measures since the regime was created in 2013, and which have had more than 12 months to improve.

Of these, only five exited special measures within a 12 month period. All these were from the original 11 placed in the regime in 2013.

The Care Quality Commission’s guidance from 2014 said: “It is intended that the usual period of time a trust remains in special measures will be a maximum of 12 months, although this may be extended in some circumstances”. It added that an extension would “not normally exceed six months”.

Greater Manchester leads in achieving extended GP access

Greater Manchester is currently ahead of the pack for achieving extended GP access, according to data published by NHS England.

The region, which recently published a major transformation plan for primary care in its area, has the biggest percentage of patients with access to “full” extended GP access.

What is full access? NHS England defines it as “pre-bookable” appointments made available at the weekends and at least 90 minutes available before 8am or after 6pm on weekdays.