HSJ Catchup: Next steps for the 5YFV, GP services rated, and takeover cancelled

Forward view delivery plan released

NHS England has published Next Steps on the NHS Five Year Forward View, setting out what the original forward view has achieved since 2015 and the NHS’s priorities for the next two years.

Here is our round-up of what you need to know about the most important NHS policy document of the year.

• EMERGENCY CARE: STPs and vanguard sites will be held to account on how well they can contain the growth in accident and emergency admissions and bed days over the next two years. New care model vanguards will be docked funding if they do not successfully reduce A&E activity.
• INTERVIEW: Simon Stevens says the NHS is trapped in the “reinforcing cycle” of increased demand requiring higher investment, but the delivery plan was “practical discussion” for year ahead.
• ELECTIVE CARE: NHS England has acknowledged that the service is unlikely to hit the 18 week elective waiting time target in the next two years.
• STPs: NHS England has announced the nine areas most likely to evolve into “accountable care systems”. NHS Improvement and NHS England to adopt “one stop shop” approach to regulation towards these systems.
• PRIMARY CARE: GP practices will be divided into regional hubs covering populations of up to 50,000 as part of plans to revolutionise primary care at scale in two years.
• MENTAL HEALTH: At least 150 new inpatient beds for children and young people with mental health problems will be available by 2019. The global digital exemplars for mental health have also been named.
• WORKFORCE: NHS England has said the service will need more nurses by 2020 and has announced a series of reforms to increase numbers, as well as reforms to enable more flexible working.

The best and worst areas for primary care

In-depth HSJ analysis has, for the first time allowed us to have a detailed picture of the quality of GP services in every area of the country.

We’ve analysed more than 6,000 Care Quality Commission GP inspection reports. Although the CQC has only released 84 per cent of GP ratings to date, the data has revealed interesting variations already.

There is wide variation across the country, with five CCGs with at least 10 per cent of practices rated inadequate. In contrast, 32 CCG areas have at least 10 per cent of GPs rated outstanding, with four of those having more than a fifth of GPs in their region rated outstanding.

• See the GP performance broken down by region

Sharing chief officers increased by 62 per cent

The number of CCGs sharing chief officers has increased by more than half in six months, HSJ analysis has found.

There are now 83 CCGs (out of 209) sharing accountable officers or chief officers – 62 per cent more than in September, when there were 52.

HSJ will be tracking the changing CCG landscape of our new map.

Latest financial measures for trusts

With the end of this financial year fast approaching, NHS Improvement guidance leaked to HSJ has revealed the latest measures being used to get trusts to meet their control totals and get provider sector finances back on track.

The documents show:

• NHS trusts will not be penalised for missing waiting targets in the last three months of 2016-17. The Q4 allocations from the sustainability and transformation fund will be paid in full only if headline financial targets are met, and could total £800m.
• Technical accounting measures and “a material number of land sales” have helped trusts improve their forecast deficit this year.
• NHSI questions whether funding earmarked to help NHS trusts cope with winter pressures actually reached them.
• Twelve trusts will work with management consultants to improve their finances.

Meanwhile, in the commissioning sector, NHS England’s latest board papers show that CCGs’ combined deficit forecast for the year has worsened by £180m in two months.

At the end of December, NHS England had forecast a year-end deficit of £370m for CCGs – but as of February (with one reporting month to go in 2016-17) the forecast stands at a £550m deficit.

Community services takeover cancelled

The planned takeover of Liverpool’s troubled community services has been halted, NHS Improvement has announced.

Bridgewater Community Healthcare Foundation Trust had been selected in November as the preferred provider to take over the £77m contract from Liverpool Community Health Trust.

The regulator had paused the planned takeover last month following Bridgewater being rated requires improvement by the Care Quality Commission.

Veteran political columnist bids adieu

Forty years after filing his debut HSJ article, Michael White’s final column has been published.

Four health secretaries and two NHS England chief executives have paid tribute to HSJ’s retiring political columnist.

• Michael White’s greatest hits

Brexit warning

A coalition of health and social care providers has warned Theresa May she must protect the UK’s ability to recruit and retain staff, as she starts the process of removing the UK from the EU.

The PM triggered Article 50 on Wednesday, beginning the country’s withdrawal from the EU.

The Cavendish Coalition of 34 health and care organisations has set out what it thinks the government needs to focus on during its negotiations with the EU to maintain safe services.

• What does article 50 mean for the NHS?