Daily Insight: We regret to inform you we’ve decided to move forward with another bid

There has been public “disappointment” from several trusts, unsurprisingly, who were among the 123 who submitted bids to join the government’s “new hospital programme” — yet were refused.

In a remarkable spectacle of waste, diversion and politicking, 128 bids went in for an advertised eight spots in the “40 new hospitals” list — yet, after much delay, only five of them were finally accepted. 

HSJ has revealed the full list of projects which bid. All five of the successful bids were for acute hospitals with unsafe roof planks.

One rejected scheme was to replace a 1960s tower block at Wycombe Hospital, now permanently covered in scaffolding to help monitor its condition and aid remedial works costing around £2m per year. 

Meanwhile, no new mental health schemes were accepted onto the programme, and there is scant representation of mental health among the full 40. It prompted a chief executive to compare a lack of investment into the sector’s estate to “institutionalised discrimination”.

Almost 50 capital projects from mental health trusts attempted to win one of the final places on the NHP, with some organisations submitting unsuccessful bids for buildings over 100 years old and constructed without modern care practices in mind. 

Bradford District Care Foundation Trust said it was “very disappointing” to find out its bid to replace “wholly unsuitable” wards designed in the 1950s had not been accepted, adding: “Still no parity for mental health in the total NHP funding allocation so far.”

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Payment by results, according to Sir Jim Mackey, is the only game in town.

So much so, that integrated care boards were unable to come up with any alternatives – with the formal process prompting just two local requests to alter the supposedly controversial funding model.

“It’s easy enough for people to say ‘I don’t like PbR’,” the elective recovery boss said on a webinar earlier this week. “Well, when you think of the alternatives, actually there’s not that much you can do that isn’t more complicated.”

It’s clear Sir Jim is no fan of the Elective Recovery Fund model used last year, when NHS England tried to meld block contracts with some limited adjustments for over- or under-performance.

In practice, the adjustments were never implemented as trusts were allowed to keep funding even if they missed the targets.

Sir Jim said PbR – part of the successful New Labour formula, albeit alongside mounds of extra funding and staff – was the “only tried and tested method” that had worked to cut waiting lists.

This time, he said, it was needed to “send enough of a signal that the NHS needed to do more work [and] address its productivity issues”.