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“We do not have confidence that we can deliver it in full but are committed to trying”.
That was the brutally honest assessment of one integrated care board about its financial plan for the 2023-24 year.
Integrated care system financial strategies – which include commissioning bodies and their member trusts – this year rest on savings targets that are reaching eye-watering levels, with a national average of nearly 6 per cent – the equivalent of £6bn – and at least one system as high as 8 per cent.
The efficiency targets have been ratcheted up over the last few months as NHS England squeezes ICSs to find more savings, after they warned of major deficits.
Some areas have resorted to pencilling in hundreds of millions in as yet unidentified savings, and then declaring a balanced financial plan.
NHS Providers’ boss Julian Hartley said the cost-cutting challenge was “significantly harder” than in previous years, when targets of around 4 per cent were set at the start of the year, and often not achieved.
The problem is that many providers are running down or have exhausted any reserves they built up during covid.
Speaking privately, one trust chair said: “It’s a really tough ask if you didn’t boost your balance sheet. You’ve got nowhere to go.”
Wanted: top CEO for toughest ICS
Are you a good CEO who’s up for a challenge? Then perhaps you’ll be tempted to take on one of the hardest NHS management jobs at local level.
That job is the CEO of Devon Integrated Care Board, with incumbent Jane Milligan announcing her retirement later this year.
Her job is a tough gig.
For years, the health economy has grappled with poor operational and financial performance – always under the beady eyes of NHS England.
Ms Milligan arrived two years ago and has been unable to turn around the ICS’ fortunes. Perhaps this was impossible, given the ongoing pandemic and subsequent upheaval caused by the latest health reforms.
Earlier this month the ICS declared it would record a £42m deficit and miss the 65-week elective target by next March in its revised operating plan to NHSE. All while hundreds of patients continue to wait two years for care, and despite the external “support” so often parachuted in by NHSE.
Devon cannot be unfixable, but the changes required are likely to be radical. Locals wonder if new finance chief Bill Shields fancies a go. If not, finding another candidate may – yet again – prove difficult.
Also on hsj.co.uk today
NHS England’s latest monthly waiting list statistics delivered the alarming headline figures we have become accustomed to – but was there a rare chink of light peeking through the gloom, asks James Illman in Recovery Watch. And in Comment, Hannah Hayes says that to address prompt discharges, collaboration between trusts and system partners is crucial.
