The must-read stories and debate in health policy and leadership.
Commentators who are sceptical of the health service like to portray it as a bottomless pit that swallows up ever-increasing amounts of taxpayer cash shovelled in by hapless ministers.
As simplistic as that may be, it goes some way to explaining the intense pressure being exerted on integrated care system and trust directors to produce balanced financial plans for 2023-24.
Finance boss Julian Kelly last week admonished trust CEOs for not yet having a balanced plan nearly a month into the financial year, sources told HSJ, with around a quarter of trusts yet to get to acceptable financial plans.
NHS England is looking over its shoulder at the Treasury, which will be questioning why ICSs are warning of a £3bn deficit, despite the NHS receiving a funding boost at the autumn statement.
Trust CEOs said NHSE was now “turning the screws” to squeeze out more savings. As one put it: “Every trust in the country is having to go back and take more out of its budget.”
The risk, as has been noted before, is that the NHS ends up with financial plans that balance on paper but don’t survive long into the year.
Somerset’s chance to shine
Mention the words “NHS merger” and you may be reminded of difficult organisational changes in places such as Liverpool, Birmingham, Bristol and Dorset.
But in Somerset, local NHS chiefs have quietly been going about their structural reform in a patient and seemingly successful way.
Three NHS providers have become one during the last five years, and the result is England’s largest integrated care trust with a turnover approaching £1bn.
Just to add more uniqueness to proceedings, the trust – Somerset Foundation Trust – is the only NHS provider in its ICS. With Somerset’s councils also merged into a unitary authority the ICS membership looks pleasantly slim.
No wonder, then, that SFT chiefs want to make the most of their opportunity to deliver truly integrated care.
In an interview with HSJ, the trust’s CEO Peter Lewis said the aim is a “powerful” transformation from hospital care to community/home care.
Of course, this concept is not new, and sceptics will say the NHS has been trying to do this for the last decade (at least).
But it feels like the levers are more in position in Somerset than they have been anywhere else. This is a unique chance.
Also on hsj.co.uk today
“So many players”. That was the reaction of Bristol, North Somerset and South Gloucestershire ICS chief executive Shane Devlin upon his move to the English health system from Northern Ireland. Nick Carding speaks to him in this week’s West Country Chronicle. And in news we report that integrated care boards must meet immediately with NHSE if they think they are breaching delegation terms for primary pharmacy, optometry and dentistry commissioning.
