• Funding for success regimes largely spent on consultants, legal advice and establishing small core programme teams
  • Sources tell HSJ funding is welcome but “modest” compared to challenges the areas face

NHS England has allocated just over £20m to the three areas in the national success regime programme to date, HSJ can reveal.

Information released under the Freedom of Information Act said £3.5m was given to the three troubled health economies in 2015-16 and a further £16.5m was allocated from the transformation fund for 2016-17 (see table, below).

The three areas placed in the success regime in June 2015 were: Essex, later reduced to the mid and south areas of the county; northern, eastern and western Devon; and west, north and east Cumbria.

Sources familiar with the regimes, including one senior manager at an affected organisation, told HSJ the funding was welcome, but “modest” compared to the projects they were being asked to undertake.

The success regimes have been ordered to come up with plans to eliminate their substantial deficits and shore up long term sustainability. Essex, for example, has pledged to clear its £216m deficit by 2018-19. Some local sources said it was “unrealistic”, and NHS England’s Essex area director Andrew Pike admitted the target was “a big ask”.

NEW Devon has been allocated the most funding to date – £7.4m, with £6m allocated for this financial year. Essex has received £6.4m and Cumbria £6.2m across the two financial years.

Funding for each success regime area
Area 2015-16 2016-17 Total
Mid and south Essex £0.9m* £5.5m £6.4m
NEW Devon £1.4m £6m £7.4m
West, north and east Cumbria £1.2m £5m £6.2m
Total £3.5m £16.5m £20m
*£200,000 was provided by NHS England’s Midlands and East regional office

The funding has largely been spent on external support from consultants to help draw up plans, legal advice, and putting together core programme teams largely consisting of a few senior managers.

The data revealed the Essex regime spent £18,000 on legal advice from law firm Capsticks in 2015-16 related to establishing the arrangements for a new leadership team to manage the three acute trusts in the patch in a “group model”.

A senior figure has previously expressed disappointment that they were forced to get advice externally, rather than being able to call on system leaders for guidance.

UCLPartners managing partner Professor Sir David Fish, who spent three months as chair of the Essex success regime, said earlier this year there was “disappointment about the apparent national nervousness and uncertainty on group models”. Local leaders were forced to get external legal advice “rather than more senior direct input from NHS Improvement”, he said.

Essex spent the rest of its 2015-16 allocation on two pieces of analytical and planning work by Boston Consultancy Group. It has earmarked £2m this financial year for “technical and professional advice”, though providers had still not been selected when the data was collected earlier this month.

The Cumbria regime spent £20,000 on legal advice in 2015-16, with the remainder spent on external consultants to help draw up plans, a core programme team, and an exercise to gather input from across the health economy.

The NEW Devon regime spent the bulk of its 2015-16 funding on contracts with QI Consulting and Attain Commissioning Services, which involved developing analytical and planning work.

It had yet to select providers when the data was collected, but the larger areas of spending included £500,000 earmarked for communications and engagement over the next two years.