NHS England has written to clinical commissioning groups to give ‘clarity’ over statements issued to providers by Monitor and the NHS Trust Development Authority this week.

  • Dame Barbara Hakin writes to local commissioner to clarify implications of Monitor/TDA letters
  • Regulators suggest NHS England would require new action from CCGs
  • Dame Barabara’s letter implies no changes to current CCG reporting requirements

NHS England operations director Dame Barbara Hakin sent a letter to CCG leads and NHS England regional directors and directors of commissioning operations this morning.

The letter said it had “become clear” CCGs would “welcome clarity” on some points in the provider regulators’ letters, which asked trusts to take new measures to try to reduce the huge deficit predicted by the sector this year, and to revise their financial plans.

The Monitor and TDA letters, sent on Monday, said that “in addition to these initiatives on the provider side NHS England have agreed they will be requiring CCGs” to take a number of steps.

Dame Barbara’s letter explains several of these steps outlined in the regulators’ letter.

Dame Barbara Hakin

Dame Barbara Hakin’s letter ‘reaffirms’ that CCGs should continue fining providers for breaching RTT the target

Monitor and the TDA said CCGs were being asked to be “transparent” with NHS England and the Department of Health about any “uncommitted reserves so that any potential upside in commissioner budgets are known”.

This has concerned some commissioners. NHS Clinical Commissioners co-chair Steve Kell told HSJ earlier this week: “The letter implies there’s a risk of [national officials] going for reserves, but we can’t get into a system where we rob Peter to pay Paul. CCGs are statutory bodies which are already transparent about their finances.”

Ahead of Dame Barbara’s letter, Dr Kell said “there is a lack of clarity about what is being asked” of CCGs.

“The letters… from Monitor and the TDA have clear implications for patient expectations and NHS performance. They also seem to be at odds with CCG assurance and financial reporting processes,” he added.

The NHS England letter implies no changes to current CCG reporting requirements. She said CCGs will “continue to provide accurate information on their revenue and financial position to NHS England”.

The letters on Monday said CCGs would be told to be “transparent” about revenue from any provider fines “so that commissioner decisions on how these should be deployed can be taken in the light of the need to deliver key standards and the overall financial position”.

Dame Barbara said CCGs had previously been asked to publish details of fines given to providers on a quarterly basis. She added: “All CCGs should have already implemented these changes, and we will keep the frequency of reporting under review.”

Her letter also “reaffirms” that CCGs should continue fining providers for breaching the referral to treatment incomplete target and to “suspend sanctions” on the admitted and non-admitted targets, in line with the announcement in June that these two targets would be abolished.

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