Stevens: Funding growth may depend on 'transformation' plans

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Health economies’ receipt of their share of the NHS’s £8bn funding growth for coming years could depend on them agreeing shared five year ‘sustainability and transformation’ plans, NHS England chief executive Simon Stevens has suggested.

Stevens proposes “nascent health systems” produce five year, whole system “sustainability” plans
Each systems’ share of funding growth could depend on providers and commissioners jointly planning for transformation
Stevens criticises “mucking about” with FT pipeline and trust acquisitions

In a speech at the King’s Fund this morning, Mr Stevens said next month’s comprehensive spending review was an opportunity to radically change the NHS approach to planning.

He said NHS England and the new provider regulator, NHS Improvement, would propose providers and commissioners come together in “nascent health systems”. These “population oriented health partnerships” would plan how services should evolve and become sustainable over the next five years.

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Every area should produce a sustainability and transformation plan by summer next year, Mr Stevens said. He suggested that doing this may be directly linked to those areas receiving their share of the £8bn real terms funding which the NHS is expected to receive during the rest of this Parliament.

Mr Stevens said he wanted to “change the defaults on what the next five years need to look like”.

‘A lot of time has been spent mucking about on FT pipelines’, Simon Stevens said

He said without these plans health economies may only be given “base case” funding.

“In order to get your share of the extra, you’ve got to come together, as commissioners, as providers in that area, as communities, and agree a shared sustainability and improvement plan,” Mr Stevens said.

“It’s the agreement of that plan, with a series of milestones, that unleashes the extra funding that we’re hoping to get from the spending review.”

He also said that national leaders were “open to ideas” and “still thinking through precisely how we do this”.

NHS England is expected to send a letter to commissioners in the coming days on the planning process for 2016-17 and the following three years.

Mr Stevens also said he believed the foundation trust pipeline and organisational mergers were distractions to progress, and should be set aside.

“We are frankly kidding ourselves if we think the non-FTs are going to pass the kinds of criteria that have been set by Monitor,” he said.

“An awful lot of time is being spent mucking about on FT pipelines. It’s time to free up that time to focus on the population oriented health system we want to set up across the country.”

And, he added: “I find too many parts of the country where deep seated problems are stalemated in flawed so-called ‘acquisition processes’ that drag on for years, cost oodles in management consultancy spend and deliver slightly less than diddly squat.”

Kings Fund chief executive Chris Ham told HSJ it was the most important speech Simon Stevens had made since becoming NHS England chief executive. He said: “I see it as a big step towards establishing accountable care organisations, or accountable care systems.” However, he questioned whether the incentives described by Mr Stevens would be enough to encourage joint planning in areas where relationships were poor.

Professor Ham also said Mr Stevens’ intervention raised two immediate practical issues: what the geographical footprints of the “nascent health systems” will be and who will define them; and what the impact will be of top slicing NHS revenue allocations at the beginning of the year and releasing it later.