News / Oversight framework ‘lays bare’ pressure on NHS providers

Last month, NHS Improvement published its initial findings under the new framework. Around 40% of NHS providers in England were categorised as requiring improvement support.

The initial segmentation is the first under the new single oversight framework. NHS Improvement said 141 providers were in the top two categories – maximum autonomy or targeted support. The others require mandated support for significant concerns (74 trusts) or are in special measures (22 trusts).

The new framework assesses trusts in five categories – quality of care; finance and use of resources; operational performance; leadership and improvement capability; and strategic change.

NHS Providers head of policy Amber Davenport (pictured above) said the segmentation highlighted the hard work of trust leaders with the majority of trusts in the top two categories. But she added: ‘What the figures do lay bare is the enormous pressure the acute sector is facing. While the new [framework] marks a significant shift from NHS Improvement, as it places much greater emphasis on improvement and support, it is difficult to separate the segmentation from the difficult context in which providers are operating.

‘This is one of increasingly challenged finances, a social care system that has reached a tipping point and rapidly rising demand.’

NHS Improvement said a further three NHS providers have been put into the separate financial special measures, taking the total to eight. The body said the three organisations – East Sussex Healthcare NHS Trust, Gloucestershire Hospitals NHS Foundation Trust and Brighton and Sussex University Hospitals NHS Trust – were forecasting a combined deficit of £73m and had failed to keep up with their agreed control totals.

But NHS Improvement chief executive Jim Mackey said the five trusts in special measures since the financial reset in the summer had responded well and had identified around £100m extra in savings.

NHS Improvement said some of the original five trusts would be released from financial special measures in a few months, once they have demonstrated continued delivery of their plan and achievement of key milestones. But Mr Mackey added: ‘The three providers going into financial special measures are causing significant concern. They’ve agreed savings targets locally but are a long way from meeting them.’