Revised financial framework to have system focus

The current arrangements were introduced at the beginning of the financial year, initially until the end of July. They include nationally set block contracts between providers and commissioners, with the national bodies providing prospective and retrospective top-up funds to cover the additional costs of Covid-19. The national bodies said the arrangements would be extended into August and possibly September.

However, a paper tabled at this week’s board meeting said that, from 1 October, they intend to introduce a revised system for the remainder of the financial year. While the simplified approach to payment and contracting in the current framework will be retained, there will be a greater focus on system partnership funding and the restoration of pre-Covid activity.

NHS England chief executive Simon Stevens (pictured) said a planning letter, due to be issued shortly, would outline phase three of the NHS response to Covid-19 – where it seeks to restore services while maintaining the capacity to deal with Covid cases and winter pressures.

Other measures likely to be included in the planning letter include:

• Systems will be urged to use nationally contracted independent sector capacity to the greatest possible extent.
• Diagnostic capacity will be maximised, including help to increase workforce productivity and develop Covid-19 minimal community diagnostic hubs.
• Enhanced discharge funding arrangements will continue, with care provided for six weeks.
• Pressure on A&E will be eased with the help of NHS 111 and capital funding available to extend emergency department capacity.

The letter will also set out a number of priorities for systems, including: preparing for winter; restoring cancer waiting times for diagnosis and treatment to – at least – pre-pandemic levels; recovering as much elective activity as possible; and continuing to increase investment in mental health services in line with the mental health investment standard.

NHS England and NHS Improvement had not been due to meet until October. But Sir Simon said this week’s meeting had been added as the national bodies knew the service was entering a pivotal period where it was balancing the ongoing Covid response with the need to restore services and prepare for the winter.