News / News review May 2015

With attention focused on the general election – both before and after Parliament formally ended on 26 March – and the health issues that would be debated, April was a relatively quiet month. Still, as so often this year, NHS finances remained in the headlines. 

 Monitor announced that it had reached agreements with a number of trusts on their finances. Following investigations by the regulator, Great Western Hospitals NHS Foundation Trust and King’s College Hospital NHS Foundation Trust agreed plans to improve their finances. King’s also agreed a strategy to reduce waiting times following an investigation into services at the Princess Royal University Hospital. Although Monitor acknowledged progress had been made, it insisted this was insufficient and the challenge was greater than initially believed. Monitor said Swindon’s Great Western trust had breached its licence as it lacked both a robust financial recovery plan and a plan to ensure it continues to provide services for patients in the long term. The trust needed to increase its efficiency, for example with how well it spending on agency staff, and how effectively it discharges patients once treatment is complete.

 The regulator added that Northern Lincolnshire and Goole NHS Foundation Trust was developing a short-term plan to improve its financial position. The regulator also agreed measures that will see the trust working with commissioners, local authorities and patient groups to develop a separate plan to ensure sustainable services in the longer term. The three-site hospital was put in special measures following the 2013 Keogh review. The Care Quality Commission took it out of special measures in July last year following an inspection. However, Monitor said its finances have since deteriorated.

 Monitor also opened an investigation into the financial sustainability of Cambridgeshire and Peterborough NHS Foundation Trust. The regulator said that while the trust is meeting its fiscal projections, it faced financial challenges in the long term. It will seek to understand the financial risks and challenges faced by the trust. It will also examine whether the trust leadership has a good understanding of the challenges and is developing effective plans to deal with them. Trust chief executive Aidan Thomas (right) said the investigation was a ‘formality’ and was launched as a result of its successful bid for local older people’s healthcare and adult community services. The trust would demonstrate its financial plans were robust and sustainable, he added.

 A survey on the future of general practice for the British Medical Association said a third of GPs were considering retiring within the next five years. The large-scale poll, which canvassed 15,560 GPs working in the UK, said GPs were worried about the impact of their workload on the quality of patient services, while only 8% felt the standard 10-minute consultation time was adequate. The essentials of general practice were continuity of care; trust and confidentiality between GP and patient; and holistic care. GPs said the factors that would help them deliver these were increased core funding (76%); more GPs (74%); and longer consultation times (70%). 

  
In Northern Ireland, health minister Jim Wells announced a £15m investment package in GP services, including up to £3.1m for out-of-hours GP services and up to £1.2m to help GPs meet demand for blood tests and other diagnostic work in the community. The package also includes up to £300,000 to recruit and retain GPs; £10m that will be available to lend to GPs to upgrade and expand their premises; and £350,000 to meet the ongoing costs of these new premises.

 A briefing paper from the NHS Confederation and partnership body Think Local Act Personal warned that personal health budgets in mental health could lead to changes in commissioning decisions. Personal budgets in mental health – key points on implementation said patients may opt to spend their personal budgets on non-traditional treatments, such as training courses and help around the home.

 The Health and Social Care Information Centre (HSCIC) published provisional information on patients’ views of their health outcomes. The HSCIC said that, for common elective procedures in 2013/14, around three-quarters of pre- and post-operative questionnaires were returned. Comparing pre- and post-operative responses to condition-specific questions, improvements in patients’ conditions were recorded for: 96% of hip replacement respondents; 93% of knee replacement respondents; and 83% of varicose vein respondents.

 A new body is needed to oversee workforce planning and commission education and training places in NHS Wales, according to a review for the Welsh government. The Health professional education investment review also found a need for stronger relationships with professional regulators; called for a new 15-year strategic vision; and urged the body to foster a greater emphasis on offering young people the chance to experience the range of career opportunities in the NHS.

 Following the closure of the Audit Commission on 1 April, the Department of Health posted a note on the transition to the new local audit regime on its online finance manual. Current audit contracts are in place up to the 2016/17 financial year. After the transition period, NHS trusts and clinical commissioning groups will have to appoint their own auditors. If the transition period is not extended, auditors will need to be appointed by end of December 2016 for the 2017/18 financial year.

 To help CCGs and NHS trusts meet their new statutory duties in relation to auditor panels, as introduced by the Local Accountability and Audit Act 2014, the HFMA published draft guidance. Developed by the HFMA Governance and Audit Committee, it explains what affected health bodies must do. Panels need to be in place in the early part of 2016 so they can advise on the appointment of external auditors for 2017/18. In most cases it’s likely that the existing audit committee will be nominated to fulfil the role. The deadline for comments on the consultation paper is 15 May.