Nearly half of strategic health authorities have not evaluated the possible impact of the economic downturn on their 10 year regional plans.

A freedom of information request has highlighted sharp disparities in the way regions are preparing for the financial challenges ahead.

A great deal of effort is being made to determine how we can deliver the next stage review vision within the tighter resources available to us

HSJ asked all SHAs to provide any evaluations they had carried out into the possible impact of the economic downturn on regional commitments related to the next stage review.

Four SHAs - NHS London, NHS North West, NHS South East Coast and NHS Yorkshire and the Humber - provided evidence that evaluations had been carried out.

Slides from a presentation delivered in July revealed NHS North West chief executive Mike Farrar had urged leaders to “start actions now” to save £2bn in the three years from 2011-12.

The presentation also set out the scale of the challenges and ways they could be overcome, such as demand management and efficiency savings in areas such as back office functions.

This preceded David Nicholson’s letter to all senior NHS managers in August, asking them to consider how they would “confront the challenge of delivering the next stage review visions in a tighter financial climate”.

NHS South West, NHS East Midlands, NHS South Central and NHS West Midlands did not produce any evaluations of the possible impact of the recession on their regional visions.

NHS East Midlands said in its response it was “about to commence” this work. The response added: “I would like to take this opportunity to assure you that NHS funding will continue to grow by around 5 per cent in 2009-10 and by the same amount in the following year.

“NHS East Midlands remains committed to the 10 year vision for improving quality as set out in From Evidence to Excellence - our clinical vision for patient care.”

NHS South Central said it had not conducted any specific evaluation and remained committed to achieving its regional vision.

NHS South West produced no evaluation but did provide a presentation delivered by chief executive Sir Ian Carruthers on 5 November referring to the “revised financial scenario”.

It said its regional vision “will put NHS South West in a strong position to meet the demands of the economic challenge”.

NHS West Midlands said its strategy had been developed to ensure it was affordable and would bring financial benefits.

NHS East of England is planning to produce a document next March or April.

NHS North East exempted itself from the FOI request on the basis that publishing the information could stifle “a full and frank exchange of information”.

A spokeswoman said: “A great deal of effort is being made to determine how we can deliver the next stage review vision within the tighter resources available to us.”

Primary care trusts in the region will be making revised five year strategies for the testing financial circumstances.

The request comes after all SHAs told HSJ in October they were not planning to scale back their regional strategies in light of future spending restrictions.

SHA evidence of evaluations

HSJ asked the SHAs to provide all evaluations of the possible impact of the downturn on commitments related to the next stage review.

SHAs that provided evidence of evaluations:

  • NHS London
  • NHS Yorkshire and the Humber
  • NHS South East Coast
  • NHS North West

SHAs that did not provide evidence of evaluations:

  • NHS East of England (due to be published next March to April)
  • NHS South Central
  • NHS West Midlands
  • NHS South West
  • NHS North East (claimed exemption under FOI Act)
  • NHS East Midlands