Technical review - December 2018

NHS Improvement issued the accounts and reporting timetable for 2018/19 in November following work with the Department of Health and Social Care and NHS England. As in 2017/18, there will be a key data return at months 9 and 12, with the month 12 key data used to inform the calculation of indicative Provider Sustainability Fund allocations. A change this year to the agreement of balances process will see a provider-to-provider mismatch report issued two to three working days before the Department’s wider mismatch report. This is intended to give providers extra time to start looking at provider mismatches before the wider report is available.

 

An HFMA briefing takes an in-depth look at personal health budgets (PHBs). How it works – personal health budgets and integrated personal budgets explains what a PHB is and the history of their development in England. With PHBs a key part of plans to give people more personalised care, the briefing explores who can have a personal budget and how the budgets are calculated. It sets out the three options for making PHBs available – as a notional budget, a third-party budget or via direct payment. It also examines the emergence of integrated personal budgets bringing funding together to meet health and social care needs.

A new integrated oversight framework will form a key part of the regular performance discussions between NHS England, NHS Improvement and sustainability and transformation partnerships/integrated care systems. Alongside this, NHS England, NHS Improvement and STPs/ICSs will continue to review trust-level and CCG-level data to help agree when individual organisations need support or intervention and who should provide that support or intervention. A document setting out the CCG improvement and assessment framework for 2018/19 said the integrated framework would evolve to reflect a population-based approach to improving health outcomes and reducing health inequalities. Its development would be informed by the long-term plan for the NHS, due to be issued shortly after Healthcare Finance went to press, to ensure that the ambition described for the NHS is captured in the metrics used to assess CCGs and healthcare systems in the future.

 

NHS Improvement has published the NHS foundation trust annual reporting manual 2018/19 (ARM) – issued without consultation as there are no significant changes to the 2017/18 document. There are two new disclosures to the annual governance statement requirements. FTs must now include a statement that they have published their register of interests for decision-making staff, as required by Managing conflicts of interest in the NHS. They must also include a disclosure of how the FT ensures that workforce strategies and staffing systems are in place to assure the board that processes are safe, sustainable and effective. 

 

The move to a single collection of costs at patient-level came a step closer last month. NHS Improvement confirmed that it would not require reference cost submissions from acute trusts for admitted patient care (APC), outpatient and A&E services covering the 2018/19 financial year. This is on the back of finding that parallel collections of patient-level costs and reference costs for 2017/18 reconciled very closely to each other (within 1%). In the one case where they did not, the reason was traced back to an inconsistency in the collections guidance. Reference costs for other acute services and non-acute services will be phased out over the next two-to-three years. The 2017/18 reference costs cover £68bn of spending by 232 NHS providers – 62% of total NHS revenue expenditure. They include costs of APC (£27.7bn), mental health (£7.2bn) and community care (£5.5bn).