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.
The big NHS reset
In what HSJ’s editor called the most significant day for health policy since the 2015 general election, Thursday saw the much trailed NHS finance and performance “reset” finally happen. This involved a new financial special measures regime (for providers and CCGs), new performance and efficiency targets and the first ever CCG ratings.
- A new financial special measures regime was announced for trusts and CCGs to ensure the NHS lives within its means. Five trusts and nine CCGs have been put in the programme. This map shows all those affected.
- The Department of Health managed to keep within the element of its revenue budget “voted” by parliament, but only after receiving £417m extra of national insurance contributions due to an “administrative error”.
- New CCG ratings have also been published, with 26 groups rated inadequate. This map shows all the ratings. NHS England is intervening in all of these, including creating “single commissioning leadership structures” in Surrey and the South West.
- CCG efficiency targets have gone up 50 per cent on last year. Fines for trusts missing targets have also gone up.
- Local NHS organisations are expected to agree two-year operational plans by the end of December, with NHS England and NHSI saying they will release joint planning guidance in September.
- Performance trajectories reveal that more than a third of hospital trusts will still be missing the four hour A&E waiting time target by March 2017.
- Twenty-six trusts have not agreed control totals with NHSI, and 16 of these are predicting more than £400m in deficits for 2016-17.
- Trusts could face financial penalties from NHSI for over-recruiting staff.
- A cap has been introduced for the pay of interim managers working at CCGs.
Trusts get moving on efficiency
Last month, NHS Improvement chief executive Jim Mackey and chair Ed Smith wrote to every trust chief executive telling them to begin planning for consolidating back office and pathology services, and “unsustainable” planned care services.
On Tuesday evening, the next NHSI missive landed – a letter from deputy chief executive Bob Alexander setting out how these plans should be worked up.
The two page proposals expected to be turned around in eight working days could be the very definition of a “quick and dirty” plan to get the NHS out of its financial hole.
Simon and Bruce answer MP’s questions
NHS England’s chief executive and medical director appeared at the Commons health committee on Tuesday afternoon. Here are the main things we learned from Simon Stevens and Sir Bruce Keogh’s questioning by MPs:
- Mr Stevens reiterated his plea for more funding in the shape of a capital infrastructure fund. Mr Stevens said: “My personal point of view is that it will be the ideal moment to consider an upgrade in NHS infrastructure.”
- Sir Bruce gave an extensive view on concerns about junior doctors’ morale and conditions. He said of the contract row which has dominated the past year, and which has been linked to his work leading improvement in weekend service standards: “Things became very complicated when contract negotiations were linked to weekend mortality.”
- NHS England with other national bodies will “informally rank” all sustainability and transformation plans. Mr Stevens told the committee that October would now mark the deadline for finishing plans, and the beginning of implementation.
- The NHS England chief executive said it was “too early to say” what impact Brexit would have on the NHS, but said “there was no reason” the government should not be able to give reassurance that the NHS will be able to retain EU staff.
- On mental health, Mr Stevens said it would “not be mission accomplished by 2020” and that while the national implementation plan released would see concrete improvements in the care provided, there will still be two children out of every three not receiving timely treatment.
Big investments for mental health
The mental health sector received a welcome boost on Tuesday with NHS England’s pledge to invest nearly £4bn into hiring more staff, integrating physical and mental health services and rolling out new models of care.
Headline figures included:
- £108m over two years to integrate physical and mental health services.
- A £1.8m pilot scheme allowing six regions to take on new commissioning powers for tertiary mental health services.
- Plans on how the £365m pledged to perinatal care will be allocated.
- £12m to extend services for mental health assessments for people in custody.
New faces at the DH
While the Jeremy Hunt was one of only two cabinet level MPs to keep their job following last week’s reshuffle (defence secretary Michael Fallon being the other member of the exclusive set), there has been an almost complete overhaul of the rest of the Department of Health ministerial team.
Theresa May has given junior ministers Jane Ellison and Ben Gummer new jobs as financial secretary to the Treasury and minister for the Cabinet Office respectively; George Freeman, who as life sciences minister spanned the health and business departments, will chair the new prime minister’s policy board.