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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NHS Improvement publishes official deficit forecasts

Official figures published by NHS Improvement show the provider sector forecasting a £873m year-end deficit, against the maximum “control total” of £580m.

As revealed by HSJ previously, NHSI confirmed that initial figures submitted by trusts had summed to a combined deficit of £973m for 2016-17, and that this was reduced by £100m following discussions between the regulator and trust boards.

NHS Improvement’s quarter three report said increased pressure on emergency services caused “one of the toughest winters on record”, and resulted in thousands of escalation beds being open each day and the loss of elective income due to cancelled operations.

Meanwhile, HSJ analysis shows which trusts are performing best, and worst, against their financial plans in 2016-17.

Budget plans revealed

There could be more money on the way for the social care sector – but it will have strings attached.

HSJ revealed on Thursday that the Care Quality Commission’s role could be extended to regulating local councils’ use of additional funds for social care, which are expected to be announced in next month’s budget.

Theresa May was heavily criticised following last year’s autumn statement for failing to provide additional funds for health or care. Senior NHS leaders have said any additional funds from the government should first go to social care. The PM did set up a Cabinet Office review of social care and integration at the end of 2016, which is understood to be looking at both short and long term action.

Several sources with knowledge of the new plans said talks were taking place between the Treasury, the Department of Health and the CQC.

The funding was described to HSJ as “short term stabilisation money” for social care, though the amount, timing and mechanism for the funding remain unclear.

NHS director suspended

An NHS England director is being investigated by police on suspicion of voyeurism, it has been confirmed.

HSJ reported on Tuesday that Jonathan Fielden, the deputy medical director and director of specialised commissioning, was away from his NHS England role and had been restricted from contact with patients by the General Medical Council.

Bedfordshire Police has confirmed that a 53 year old man, from Biddenham, has been arrested on suspicion of voyeurism. A police spokeswoman added that he has been bailed until 23 March while enquiries continue.

An NHS England spokesperson said: “Dr Fielden is currently suspended from his post as director of specialised commissioning.”

Dr Fielden, a high profile and well regarded medical leader, was previously medical director at University College London Hospitals Foundation Trust. His role at NHS England involves oversight of its huge specialised commissioning budget, and important reconfiguration and prioritisation decisions. 

Dr Fielden was approached for comment.

Emergency care targets delayed

HSJ revealed on Tuesday how details of an overhaul of emergency care targets have been delayed, as senior figures in the health and care system await a potential government intervention to support social care services.

An announcement on a package of measures including setting out how a new high profile indicator for the A&E system would work, a shake-up of NHS 111 and out of hours services, and changes to ambulance response time measures, had been widely expected in recent weeks.

However, officials realise the recent major failings in A&E are closely linked to adult social care because of the impact on delayed transfers and bed capacity. This argument has rightly gained traction in the media, and ministers are now widely believed to be considering an intervention on social care.

Planning the end of CCGs

In the leader column this week, HSJ editor Alastair McLellan has said CCGs have the “privilege of being able to prepare for their own end and to determine its time and circumstances”.

He is not calling for clinical commissioning groups to be scrapped tomorrow, but points out: “NHS organisations have a limited lifespan, and their demise tends to be traumatic for those involved and wasteful of  time and money.” This needn’t be the case for CCGs.

“Instead CCGs should recognise that changes taking place across the NHS – most importantly new models of care and the organisational landscape that supports them – will require a shift in the way services are planned and funded. In turn this spells a certain end for CCGs as envisaged in the Health Act 2012.”

GPs warned over buying discounted vaccines

A story on hsj.co.uk shows just how difficult commissioners can find protecting the NHS pound from pharmaceutical companies – particularly when they are aided by local GPs.

Commissioners in the West Midlands have raised concerns that they may be paying more on flu vaccines then they ought to, as GPs could be ordering them at a discount direct from pharmaceutical companies and then claiming the full price back without their clinical commissioning group’s knowledge.