Trust leaders notified of extra funding allocations with 'clear expectation'

The letter from NHS England and NHS Improvement confirmed the “clear expectation” that initial payments will improve the financial position, rather than fund new initiatives.

The letter, seen by HSJ, said the first tranche of funding will reflect the cost of extra winter activity that is “already in operational plans”, and will ensure a “corresponding improvement in the reported month seven forecast outturn financial position”.

This tranche has been allocated on a fair shares basis to acute providers based on their urgent and emergency care activity.

On Wednesday, HSJ reported at least half of the £335m would be used in this way with the remainder available to areas that can commission new capacity that had not been arranged prior to the budget.

The second tranche is for new initiatives to improve accident and emergency performance over winter and will be paid when implementation is confirmed. With this tranche, trusts have been told what level of A&E performance they are expected to deliver in the final three months of 2017-18.

HSJ understands there has been debate at a national level about how to present and communicate the allocations.

The letter also acknowledged trusts’ concerns about the “very short lead in time for the funding” and that the need to increase capacity as quickly as possible could lead to increased use of bank and agency staff.

However, it said trusts must adhere to the spending ceilings and pay caps for agency staff unless there are exceptional circumstances.

A spokesman for both NHS England and NHS Improvement said: “The health service has prepared more intensively and comprehensively for winter than ever before.

”Letters to NHS organisations sent today are their allocation of the extra winter funding announced as part of the recent budget. The funding will support extra hospital and community beds which - alongside the 1,150 beds already freed up from [reduced] delayed transfers of care - means that more than 2,500 extra beds will be available over winter.

”In addition the funding covers a variety of initiatives including urgent GP appointments, mental health crisis care, and services such as community geriatricians and discharge coordination.”