Treasury demands ICSs achieve financial balance for first time

This is the first time the annual “mandate” for NHS England has included a direct reference to the financial performance of ICSs, as previous documents have referred only to NHS trusts or clinical commissioning groups.

However, the document does not specify what the expectation is around the number of ICSs that will need to be in financial balance. Several systems were running large financial deficits before the coronavirus pandemic.

The mandate, which is set by the Treasury and Department of Health and Social Care, may carry added significance from April, given ministers desire, expressed in the new legislative proposals, to take a tighter grip on how the NHS is run.

The financial requirements listed in the mandate are; a balanced overall NHS position; number of NHS organisations in financial balance; number of NHS systems in financial balance; NHS productivity growth rate.

It says further metrics are to be agreed in July.

Meanwhile, planning guidance issued today confirms the block contracts currently in place for providers [introduced in response to the coronavirus pandemic] have been rolled over until October 2021.

However, additional funding will be made available to systems that achieve specified levels of elective activity. ICSs will be responsible for deciding how to allocate any additional funding to their local organisations.