News / News review – September 2021

31 August 2021 Seamus Ward

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As always, funding will be a major issue. The NHS in England was yet to hear its funding settlement for the second half of the financial year as Healthcare Finance went to press, but services in Wales and Scotland have received additional finances to support both Covid spending and the cost of recovery.
PORTRAIT_NR_Amanda Pritchard

In August, the Welsh government allocated an extra £551m in Covid funding for health and social care. Health minister Eluned Morgan said £411m will be spent supporting the ongoing costs of responding to the pandemic, while £140m will go to recovery of services and tackling waiting times. The ongoing costs include vaccination, testing, personal protective equipment, and meeting new infection control standards. The funding is in addition to £100m announced in May for the Welsh government’s health and social services recovery plan.

The Scottish government allocated £380m in July to help health boards with the costs of the pandemic. It includes support for the Covid and flu vaccination programmes (£77m), the Test and Protect system (£90m), and personal protective equipment (£85.5m). The remaining £127m will be used to support additional staffing costs as the hospital sector recovers, as well as equipment, maintenance and IT. The government said further funding would be available as necessary.

 

Waiting lists in England could grow to 13 million – as health and social care secretary Sajid Javid recently warned – or higher, the Institute for Fiscal Studies (IFS) has said. The institute said seven million fewer patients than expected joined the waiting list between March 2020 and May 2021. Even if only two-thirds of these patients joined the list and the NHS was operating at 95% of pre-Covid capacity, waiting lists could easily exceed 13 million and keep growing, the IFS said. According to the June figures, there are almost 5.5 million people on waiting lists, though NHS England said the service was making progress on non-urgent care, despite a busy summer, with high numbers of patients coming forward and the Covid vaccination programme.

 

The move to integrated care systems (ICSs) in England increased at pace as the government published its Health and Care Bill. Joint working under pooled funding arrangements has been in place for years, and since 2015 principally through the Better Care Fund (BCF), which supports health and care integration to help people to stay at home and live independently. Almost £7bn has been committed to the BCF for 2021/22, including £4.3bn of NHS funding, £2.1bn from the improved BCF grant to local authorities and £573m for the Disabled Facilities Grant. The Department of Health and Social Care said the NHS contribution had increased by 5.3%, in line with the NHS long-term plan settlement. But the grants will remain at 2020/21 levels.

 

The Westminster government hailed a milestone in its hospital building programme as Mr Javid opened the £35m Northern Centre for Cancer Care in Carlisle. The cancer centre is one of the 48 hospitals the government has promised by 2030 as part of its hospital building programme, the Health Infrastructure Plan. It was one of eight that had already secured funding when the programme was announced.

 

PORTRAIT_NR_Humza Yousaf_scotlandDoctors and dentists in Scotland will receive a pay rise of 3% backdated to 1 April, health secretary Humza Yousaf (pictured) announced. The award is in line with the recommendation of the doctors’ and dentists’ pay review body and follows the deal for Agenda for Change staff in Scotland of a minimum of 4% to all but the highest earners. Mr Yousaf said the award for doctors and dentists recognised their hard work and dedication over the past year.

 

Staying in Scotland, the government has opened a consultation on the creation of a new National Care Service (NCS). At a minimum, the NCS will cover adult social care, but the consultation document recognises that if a comprehensive care system is to be created, extending the scope to other services, including those for children and young people, should be considered. Social care minister Kevin Stewart said the government wanted to create a comprehensive community health and social care service for people of all ages. Local delivery boards will work with the NHS, local authorities and the independent sector to plan, commission, and deliver the services.

 

Amanda Pritchard (pictured top of page) has been appointed NHS England’s new chief executive. Ms Pritchard, who has been Simon Stevens’ deputy for the past two years, will lead the service’s bid to recover from the Covid-19 pandemic, address a major backlog of treatment, transform service delivery, and introduce structural reform. A former chief executive of Guy’s and St Thomas’ NHS Foundation Trust and a career NHS manager, Ms Pritchard is the first woman to be appointed to the post.

 

The government’s Infrastructure Project Authority (IPA) called for action on the project to deliver the new integrated single financial environment (ISFE) for England. In its annual report on major projects across government, the IPA said its overall delivery confidence assessment rating for the £300m ledger scheme is amber/green. However, it was currently rated red due to the need for sufficient resource in some key areas, such as commercial strategy and project management support. In April, the current ISFE contract – provided by NHS Shared Business Services – was extended to 2024 while its replacement is procured. The IPA also rated the New Hospital Programme, which aims to deliver 48 hospitals by 2030, as amber/red. The programme team had made progress setting up the complex scheme with robust governance, it said, but much remained to be done.

 

The Cancer Drugs Fund is to be replaced by a wider-ranging Innovative Medicines Fund (IMF), under NHS England proposals. The IMF will have ringfenced funding of £680m, and will seek to help patients with any condition to access the most clinically promising treatments. These treatments will include those where more data is needed to support the National Institute of Health and Care Excellence to make final recommendations. The existing cancer fund is worth £340m, and the expanded scheme will receive a further £340m to fast-track drugs.

 

THE NEWS IN QUOTES
'I recognise it is a huge task just to get back to where we were before the pandemic. However, we must also grasp this opportunity to adopt new ways of working and create a sustainable health and social care system that can meet the demands of the future.’

There are improvement opportunities, despite the impact of Covid, according to Wales health minister Eluned Morgan

‘The skill, determination and can-do spirit that NHS staff have shown in the face of the greatest challenge in the health service’s history means we face the future with confidence.’

New NHS England chief executive Amanda Pritchard believes the service can overcome the tests ahead

PORTRAIT_NR_sajidjavid

‘Our senior medical staff will continue to be the best paid in the UK. As well as rewarding them for their efforts in the pandemic, it will help to ensure NHS Scotland remains an attractive employment option for medical and dental staff.’

Scotland’s health secretary Humza Yousaf sees a 3% pay rise for doctors and dentists as a win-win

‘The Innovative Medicines Fund will significantly reduce the time it takes for the most promising new medicines to reach patients, including children and those with rare diseases, saving lives and giving many people hope for a healthier future.’

Health and social care secretary Sajid Javid (pictured) hails the planned extension of the Cancer Drugs Fund model

 

 

From the HFMA
As well as keeping members up to date on the latest pandemic developments in the Covid-19 update and Covid-19 reader, the association published regular blogs over the summer months.

In one blog, Patrick Mitchell, Health Education England director of innovation, digital and transformation, highlights the important role finance professionals can play in digital transformation in the NHS. Finance staff support the allocation of resources, monitor their use, and provide evidence of productivity improvements, he says. This underlines the importance of the new HFMA programme, supported by HEE, which aims to increase awareness among finance professionals and help them play an active role in delivering new technologies, he says.

PORTRAIT_NR_SanjayAgrawalUniversity Hospitals of Leicester NHS Trust respiratory consultant and HFMA trustee Sanjay Agrawal (pictured) says the NHS is now putting prevention at the heart of its planning, but finance staff must identify funding for these programmes within their local structures.

Wes Baker, Mersey Care NHS Foundation Trust director of strategic analytics, economics and population health management, blogs about the potential benefits neurodiversity, including dyslexia, can bring to NHS finance departments. And Bermuda Hospital Board chief financial officer Bill Shields delivers his latest postcard from the territory, reflecting on the differences in Covid response.

Finally, HFMA policy and technical manager Debbie Paterson looks at the year-end impact of the pandemic and the lessons the NHS can learn from the preparation of the 2020/21 annual report and accounts.

See Blogs