News / News review - May 2016

Chair Ed Smith will be joined by eight non-executives, including Professor Lord Darzi, Lord Carter of Coles and Richard Douglas (right), former director-general of finance at the Department of Health. Five executives will also sit on the board, including chief executive Jim Mackey, director of resources Bob Alexander, director of regulation Stephen Hay, director of nursing Ruth May and medical director Kathy McLean.

The new body’s in-tray is stacked with issues such as further tariff reform, costing changes and the new Carter metrics, but it immediately faced operational and financial issues. April saw the publication of the worst A&E performance figures in England since monthly reports were introduced in 2010. According to the figures for February, 87.8% of patients were seen within the four-hour target, down on the 88.7% in January. NHS England said a delayed flu spike and social care-related delayed transfers of care contributed to a decline in A&E performance in February.

NHS Improvement moved to investigate and act at trusts facing financial and operational issues. It opened an investigation into the financial position at Birmingham Women’s NHS Foundation Trust. The regulator said it would examine whether the trust needs extra support as it plans its recovery. The trust was forecasting a worse than expected year-end position for 2015/16, predicting it would have a £3.4m deficit.

NHS England does not have consistent information on the cost, access to, outcomes
and efficiency of specialised services, according to the National Audit Office. Despite taking over their commissioning three years ago, it does not have an agreed strategy for the services, it added. An NAO report, The commissioning of specialised services in the NHS, said NHS England has found it challenging to control the rising costs of these services, with the budget increasing on average by 6.3% a year between 2013/14 and 2015/16.

The King’s Fund set out three challenges for the NHS in England: sustaining existing services and standards of care; developing new and better models of care; and tackling the challenges by reforming the NHS from within. The think-tank reiterated its proposal to implement an integrated system for health and social care with a single local commissioner as a way to tackle the challenge on sustaining services. On transformation, it called for a national workforce strategy to ensure the workforce was fit for purpose and aligned to the new care models set out in the Five-year forward view.

There was change at another arm’s length body – the Health and Social Care Information Centre is to be renamed NHS Digital from July and will have a new chair, Noel Gordon. The Department of Health said the new name for the data, analysis and IT systems provider will build public confidence, recognition and trust. Mr Gordon is currently non-executive director and chair of the specialised services commissioning committee at NHS England.

A Nuffield Trust briefing focused on emerging changes in primary care and how digital technology can help managers and clinicians to deliver them. The paper looks at e-digital requirements for new primary care models and examines how technology can underpin a series of changes enabling primary care to meet its challenges. Drawing on six case study sites using new technologies, the briefing looks at innovations such as shared health records, patient portals for booking, remote consultation and telehealth.

The Welsh government will spend £60m over the next year to join up health and social care services. This includes £50m of revenue funding from the intermediate care fund to improve co-ordination between social services, health, housing, education and the third and independent sectors. The remaining £10m is capital funding to support reablement or step-down services, for example.

The Senior Salaries Review Body said it was unable to recommend a pay rise this year for NHS very senior managers (VSMs). The Department of Health had not provided it with an opportunity to review a new pay framework, it said. As a result, it could not advise on the suitability of the framework or on transitional arrangements. However, the review body was at pains to say this did not mean it was recommending a pay freeze. It pointed out that funding for an average 1% rise was available, Agenda for Change staff received a 1% rise from April and in five of the last six years VSMs have not received an award. It recommended that, if the government decides to give VSMs an award averaging less than 1% this year, it should hold back the funding to allow a potentially bigger rise next year.

The implementation of new guidelines to improve hospital food could save the NHS around £2.5m a year. The Department of Health published its hospital food standards panel’s recommendations on hospital food and drink. A cost-benefit analysis, made available alongside the main report, said the guidelines were expected to cost around £7m a year. However, better nutrition in patients would reduce lengths of stay and, coupled with catering efficiencies such as reduced waste, would generate savings of £9.6m. In addition, a further £1.5m is expected in terms of health benefits to staff and patients, the analysis said.

A consultation on proposed changes to student funding for nurse, midwife and allied health professional degree places is now open. The proposals, announced in the 2015 spending review, will mean that from 2017, all new students will receive funding and financial support through the standard student support system rather than through the current NHS bursary scheme. Loan repayment terms will be the same as for other graduates. The government said two-thirds of people applying to become a nurse in the current system are not accepted. However, it said the changes would create up to 10,000 more training places by 2020. The consultation closes at the end of June.

Measures to combat conflicts of interest have been unveiled by NHS England. It said the plans would bring a stronger, more consistent approach to managing potential and existing conflicts of interest across the NHS. The measures include revised guidance for clinical commissioning groups; a new task and finish group to set rules that can be adopted across the NHS; a 2016/17 standard contract requirement for providers to keep a register of gifts, hospitality and conflicts of interest; and a strengthening of NHS England’s internal policy.

​In the media

The HFMA/FSD NHS finance census and staff attitude survey garnered plenty of attention from the press in April. HFMA policy and technical director Paul Briddock told National Health Executive only 46% of staff surveyed felt valued by clinicians in their organisation. There was a need to ensure finance staff were trained on how clinical services are delivered and for clinicians to understand better the workings of NHS finance.

Hospital Management magazine and The MJ (Municipal Journal) both took similar lines. They highlighted the fact that almost two-thirds of NHS finance staff hoped to spend the rest of their career in the health service, but only 47% expected to remain employed by the NHS until they retire. Mr Briddock said the need for the service to retain finance staff had never been higher to facilitate high-quality services with restricted financial resources.

PQ focused on the finding that only 5% of NHS finance professionals feel valued by the public, but public sector values keep them going to work. It also highlighted the gender imbalance in senior finance roles.

In Pharma Times Mr Briddock (right) also commented on last month’s Commons Public Accounts Committee report on financial sustainability and performance of acute trusts. He said the sector ‘had a mountain to climb’ and recent performance figures showed that quality of care was beginning to suffer.