• Real concern about misaligned plans
  • Control totals should be ‘believable’

The chief executive of NHS Improvement has called for “honesty” and “believability” in local five year plans due in 2019, saying there needs to be a “raising of the bar” on capacity and financial planning.

In a speech to NHS accountants this afternoon, Ian Dalton said there is still “real concern” about the misalignment between commissioner and provider plans, and that a step change is needed.

Next year, local leaders will be tasked with drawing up strategic system plans that respond to the ambitions set out in the national long-term plan, which is due to be published this month.

Mr Dalton said there will be different starting points for different areas, and financial “control total” targets will be rebased to reflect that.

He added: “We have to be honest about where we start from and we have to be honest about the capacity of the system and the efficiency you can drive. And yes we will want it to be stretching but yes we really want it to be believable. And that will be a core expectation from where I sit looking at plans of which providers are part of.

“We need plans from commissioners and providers that frankly align. I know we’ve made progress on that but I would suggest there’s still a significant way to go…. the delta between some plans and what’s been happening is a real concern.

“When it comes to thinking about next year we’re going to want to really understand not only the believability of individual plans’ part in relation between capacity and money, but also the alignment between providers and commissioners. So I think there’s going to be a raising of the bar on that.”

The previous round of five year plans, undertaken within “sustainability and transformation partnerships”, were roundly criticised for being unrealistic and unachievable, largely due to the financial assumptions within them.

The plans due next year will benefit from a more generous funding settlement, which averages out at 3.4 per cent annual increases over five years within the NHS England budget.

Mr Dalton, speaking at the Healthcare Financial Management Association conference in London, also said the plans would be created at a system level, and it is “not going to be optional” for individual organisations to take part in that.