Five-year settlement must transform services and balance books

At the Commons Health Committee hearing on NHS funding this afternoon, he was challenged on the fact that in the last few years sustainability and transformation funding was used chiefly to address financial problems in providers. Committee chair Sarah Wollaston asked if NHS Improvement and NHS England planned to ringfence some of the additional funding in the five-year settlement for transformation.

Mr Dalton (pictured) said this would be decided as part of the new NHS 10-year plan.

‘It is clearly really important that there is the time and space and resource to make the transformation the NHS needs. At the same time we need to reflect that we need to start from where the NHS is and we do have a significant underlying deficit in the provider sector.’

He added: ‘I think we have to think about phasing as well as resourcing. We have to use the new settlement to ensure both of those things are achieved. One of the debates we need to have with the service as we prepare the plan is the phasing for those two things to come together.’

MPs on the committee acknowledged the Getting it right first time (GIRFT) programme was important in driving up efficiency. However, they said some clinicians had complained there was not enough time to perform their day-to-day duties and address such improvement programmes.

Mr Dalton replied: ‘The way forward is to see GIRFT as mainstream activity. Of course the day job is very demanding, but we also have to make time to drive the improvement we need and balance the books. We have to recognise there is a significant underlying deficit in providers that we also need to fund from this settlement. There is a need to do both of those things at the same time.’

Mr Dalton said NHS Improvement was currently waiting for bids for capital from sustainability and transformation partnerships, due by the end of July. This would allow it to ‘get some further capital out this year, but also giving us an opportunity to prioritise going forward’.

Significant capital had been spent, but there was also a substantial need for further capital investment. He highlighted the £5.5bn backlog maintenance across the provider sector.

‘I look forward to receiving news in due course of capital settlement for the NHS as we go forward,’ the NHS Improvement chief said.

‘It’s clearly going to be important for us that not only do we prioritise our capital really well, but we have enough to address some of the backlog in the system that has built up over recent years. Alongside the revenue settlement we have got, we look forward to an opening of the taps on capital, which I think will be very welcome.’