News / Nicholson offers glimpse of 2010/11 framework

NHS chief executive David Nicholson (pictured above) gave foundation trust finance directors an insight into the 2010/11 operating framework at an HFMA FT finance directors forum in June. He told a packed session PCTs would need to create an ‘unallocated’ buffer in 2010/11 to prepare for the anticipated restrictions in NHS growth. He wanted the NHS to go into 2011/12 ‘with a £1bn surplus and 1% of PCT budgets unallocated’.

This is understood to mean that PCTs will need to show that 1% of their allocations are spent on non-recurring expenditure, rather than tied up in annual contracts that would be rolled forward in 2011/12.

Mr Nicholson also provided further details of his plans to review the system reform levers, such as payment by results, to see if they would operate well during the recession. He told the forum: ‘We’ve built a system that is good at building capacity. We need to assess that all the levers are recession proof.’

This did not mean ‘ditching’ reforms; reforms had to be faster not slower. But different approaches in some areas covered by the national tariff could be considered – capitation approaches for funding the care of patients with long-term conditions, for instance, as well as looking at system-wide incentives.