Next year's operating framework places a new accent on planning for worst-case scenarios and allowing 'headroom' for change.

Next year's operating framework places a new accent on planning for worst-case scenarios and allowing 'headroom' for change.

Organisations must promise to deliver at least half their cost improvements in the first half of the year.

NHS chief executive David Nicholson said the new model contract would help commissioners and providers plan better.

'Trusts need to plan for alternative scenarios. One of the things that struck me from the foundation diagnostic was that people were being asked to plan for a downside case, which they hadn't done before. The NHS tends to assume the best-case scenario and then, when it doesn't happen, they start to panic.'

Mr Nicholson said trusts needed to see 2007-08 as a year when they began 'operating as quasifoundation status, getting rid of cash brokerage' and basing business plans on cashflow rather than revenue.

Although growth for 2007-08 will be 9.3 per cent, he said that getting back money that had been topsliced this year would mean that primary care trusts would see growth of 'about 12-13 per cent on average'.