News / Stevens urges action on finances

In a speech at the NHS Confederation conference in Manchester today, Mr Stevens (pictured) said that the NHS forward view had ​outlined the need for funding between £8bn and £21bn, depending on progress in public health, service transformation and social care. The spending review settlement was U-shaped, with higher increases in the first and final years, with relatively fallow years in between. He acknowledged this had three consequences:

• It was difficult to see how capital will be found to fund service redesign of care in STP areas
• A lot of extra purchasing power is not available until 2019/2020
• 2016/17 had increased in importance and had to be reset finance and performance.

Nevertheless, he warned that it would not be prudent to assume the NHS will receive additional funding and, in any case, there was a strong argument that any extra funding should go to social care.

He added that the NHS faced three challenges this year. It no longer had ‘the luxury of time’ on implementing the Carter recommendations and, for clinical commissioning groups, the RightCare agenda. It must deliver some of the key national priorities – the forward view and other strategies and task forces, such as those on maternity and cancer, had defined NHS England’s policies and it was now time they were implemented. And it had to ‘land’ the sustainability and transformation plan (STP) process.

There would be a ‘reset’ on funding and politicians would make this clearer in July. He added: ‘This is clearly going to be headed all our ways sooner rather than later. So the earlier in the financial year that we adjust our plans to deal with our run rates so that we don't end up out of whack and then doing panic measures come the autumn, the better for everybody.

The NHS had to take a number of practical steps to stabilise its financial and operational performance, after the provider sector did not deliver its control total of a £1.8bn aggregate deficit in 2015/16.

‘Let's just be clear, finances do matter, the control totals that individual organisations will be accountable for do matter, and this is for a purpose. The purpose is that we have had to strip out 1%, call it £650m, of spending from funding that would have been available from CCGs for mental health services, community health services, primary care and other things to hold as a contingency reserve going in to this year given what happened last year. We want to be able to release that funding and spend on mental health services and community services so our delivery on these control totals will have a direct impact on our ability to free up that incremental spending for the priorities that we know we have got to resource.’

Mr Stevens added that from 2017/18 there would be a new payment mechanism for medical technical innovations, such as devices or apps, that have been shown to be cost saving or help patients with supported management. This would ‘diffuse’ innovations more quickly and remove the need for local price negotiations. NHS England would bulk purchase the technologies.