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.
Expected election aftershocks for NHS
The biggest story of the week is undoubtedly Theresa May’s decision to call a general election on 8 June. While Brexit is expected to dominate the campaigning, the poll could have significant consequences for the NHS.
In his leader, HSJ editor Alastair McLellan argues that the snap election could prove to be a net positive for the NHS.
“If we assume that we are not in for another seismic political shock, the election is likely to return a Conservative government with an increased majority,” he says.
“This would be good news – when compared to the current situation – for the NHS on four fronts.”
The HSJ news desk has also taken a look at the immediate impact of Ms May’s decision on the health service.
“More delay and frustration of change is the main immediate consequence,” our analysis says.
The service’s current leadership may feel aggrieved that they are dealing with not only the most financially straitened period in its history, but also a time of disproportionate political upheaval and uncertainty.
The atmosphere has made it even more difficult for the NHS to get on with change, particularly the reconfigurations and other contentious decisions often involved in work to contain costs and improve safety. These rely on the tacit engagement or support of politicians – and elections tend to elicit the opposite.
Health economies under scrutiny
During the election, Labour is likely to seek to make potential service closures a big campaign point. Local issues in the mix include reconfigurations in Lincolnshire, Cumbria, Dorset and Shropshire.
HSJ analysis published on Tuesday has identified the health economies with the greatest overspends both against financial “control total” targets, and against allocations/income for 2016-17, and therefore likely to be targeted by national bodies to make “difficult choices” to scale back “unaffordable” services.
National officials have begun identifying regions that are “significantly out of balance”, though there are different views about how this should be measured. One measure likely to be considered is the combined performance of a region’s NHS organisations against their 2016-17 financial targets.
HSJ has collated the latest official forecasts for trusts and CCGs on a regional basis to produce a map showing the STP areas most likely to come under scrutiny.
We have also produced a map showing the actual surplus or deficit position for each STP, which is how some national figures believe the priority areas should be identified.
Another spending crackdown
National leaders have set out new measures to control spending in health economies deemed to be “living off bailouts”, which may result in some contracts having to be revisited for the current financial year.
The latest attempt by NHS England and NHS Improvement to curb spending is described as a “capped expenditure process”, HSJ has learned, and focuses on the combined financial performance of providers and commissioners in a health economy.
It is understood that consultancy firms have been commissioned to work with some of the areas identified.
Yesterday, HSJ revealed which sustainability and transformation partnership areas are likely to be targeted by national leaders for overspending.
Although most of the 2017-18 contracts between providers and commissioners have been signed, there have been warnings over the huge efficiency assumptions built into many of the deals. This has resulted in large financial gaps, for which savings plans have not been identified.
NHS Digital nets big gun
NHS Digital has appointed the Home Office’s chief technology official Sarah Wilkinson as its new chief executive.
Ms Wilkinson carried out a major restructuring of the Home Office’s IT capabilities, overseeing critical systems supporting the UK Border Agency and the police.
The former Credit Suisse head of corporate systems technology has held other senior roles in the private sector with banks including UBS and Deutsche Bank, and 10 years at Lehman Brothers.
New CEO backs controversial hospital plan
Back in 2015, Hampshire Hospitals Foundation Trust received planning approval for a new critical treatment hospital, despite CCGs saying the plans were unaffordable. Previous estimates have suggested it would cost £150m to develop the contentious site.
The trust’s new chief executive, Alex Whitfield, has insisted building the new hospital remains the “the most sensible solution” to ensure the sustainability of acute services in the region.
Her comments come amid a review of acute services in the area. Ms Whitfield told us: “The critical treatment hospital is part of that solution. When you go through the logic that is where you end up.”
Plans for the hospital include treating patients for heart attack, stroke and major trauma; running a centralised, consultant led maternity service; and co-locating a new cancer treatment centre.
Locum doctors and temporary NHS staff hit by new tax rules will not face retrospective action over their previous tax arrangements, HM Revenue and Customs has confirmed.
NHS Improvement said it would work with trusts to reassure staff who are concerned they could be affected by tax investigations after IR35 regulations came into force this month. The new rules mean the responsibility for paying national insurance and income tax for temporary staff has shifted to the trust.