Fall back, spring forward

The clocks going back normally signals the end of autumn half-term. With virtually nobody on leave, the roads and trains are at their busiest and so, with less daylight, this all conspires to make the daily commute to and from work more challenging than ever.

It also means that Christmas is just around the corner, and for many of us that means focusing on all the things you want completed before the end of the year.

This is also the time when we start to get news of what next year might hold for the health service and our patients.

From a financial planning point of view, we already know quite a bit. We may still await a formal multi-year capital settlement, but the Department of Health and Social Care has unveiled its Health Infrastructure Plan (HIP), with the promise that this is the start of a rolling five-year programme of capital investment.

In addition, we’ve had confirmation of control total, efficiency, incentives and financial support arrangements for the next few years.

As ever the full picture won’t emerge until we see the detailed planning guidance, which would typically emerge around Christmas time. However, given the ongoing government distraction with Brexit and now a general election, it would not be a surprise if there were delays to the usual process.

This may also hamper the conclusion of a meaningful public sector spending review within the original timescales, with an inevitable impact on the level of information that can be provided in as timely way as we would all like.

The quite rapid change in NHS capital investment policy should be welcomed, particularly as the first-wave hospitals include sites where the physical estate is an obstacle to the highest quality care.

Getting these schemes from conception to finished hospital within the timescales outlined in the plan will be crucial to building confidence that the NHS can manage significant building projects and capital expenditure again.

While the headlines have all been about the big hospital rebuild projects, the infrastructure plan also holds out hope for proper investment across the system in backlog maintenance and renewing medical equipment. I look forward to seeing more detail on these initiatives, which should have a more rapid impact on our biggest areas of underinvestment across the system.

Some of the details of the new financial regime have also emerged, together with control totals and efficiency targets aimed at returning the provider sector to balance over the next few years. The pace of change is welcome.

I am sure many questions remain about how targets have been set – not least because they are predicated on everyone achieving plan this year. However, it is such a breath of fresh air to have regional teams back in place across the system.

Colleagues up and down the country are expressing optimism that the regional oversight will bring some much needed local insight and pragmatism to solving local problems.

As I near the end of the branch conference season, I wanted to say how impressed I have been with the way each branch puts together its event. While slightly different, all share the common thread of a dedicated branch chair and committee, supported by their local HFMA members, who have attended these local events in their hundreds.

This is a great reminder that our association’s strength comes from its branches and individual members!

Contact the president on [email protected]