• NHSI to take “long, hard and important look” at the configuration of clinical services and the organisational structures around them
  • Ian Dalton could not announce what the provider sector’s financial plan would be for 2018-19, as discussions are still taking place
  • He said there will be a “new approach” to financial control totals from 2019

NHS Improvement will take a “long, hard and important look” at the configuration of clinical services and the organisational structures around them, its chief executive said this morning.

In a speech to the NHS Confederation conference, Ian Dalton also said he could not currently say what the provider sector’s financial plan would be for 2018-19, as discussions are still taking place with a number of trusts.

One of the key objectives set out in the planning guidance in February was for the sector to deliver a breakeven position this year.

He also said there would be a “new approach” to financial “control totals” from 2019-20, and the deployment of sustainability funding.

Speaking of NHSI’s function moving from regulation to improvement, Mr Dalton said: “We’ll be focussed on how we can help get the best from the NHS’s workforce, helping build leadership capacity across the NHS, and how we can support leaders.

“We’ll be focussing laser-like on the NHS’s productivity and capacity for improvement… and we’ll be having a long, hard and important look at the configuration of clinical services and the organisations we put around them to make sure they’re fit for purpose going forward.”

Asked whether it is realistic for the provider sector to plan for breakeven in 2018-19, Mr Dalton said: “We have asked people to granulate their plans again. We’ve got plans in that show frankly there’s more to do to get to a place where activity, finance, and workforce…. can be properly balanced.

“I wrote to acute trust chairs last week to ask them to have a look again at a board level at the balance between those things. I think before we pronounce on what the NHS is going to do this year I have to get a clear sense that those things are properly understood and in balance.”

The letter, seen by HSJ, said NHSI would undertake a review of financial performance in the first quarter of the year, with “high risk” providers potentially invited to a regional review session.

On the previously announced integration of NHSI and NHS England, Mr Dalton said: “(There will be) a single approach to the NHS’s money at a national and regional level, and that will be backed from 2019 onwards by a new financial architecture which will replace that which we’ve had for the last couple of years.

“And (there will be) a new approach to control totals, to sustainability and transformation funding, and to the sometimes punitive rate of interest that we charge our most distressed organisations as they seek to pay their staff and suppliers.”