- Systems offered extra funding to bring down year-end deficits.
- Sources claim money is reward for systems that have “played along with NHSE”.
- Local leaders pressured to use “accountancy tricks” to improve position, source says.
Let’s hope it’s the end of Maverick CEOs in the NHS. NHS England is offering extra revenue funding to systems that agree to hold their financial positions for 2022-23 at an agreed level, HSJ has learned.
Extra funding is being distributed in an apparent attempt to improve year-end positions as more systems begin to formally forecast deficits. Until now, most integrated care systems have maintained they would break even, despite overspending during the year so far.
NHS England is looking to reward people who are playing the game, and are doing serious financial discipline.If you hit your control target this year, that pays dividends in terms of your capital allocation for next year, for example. But also, if you are looking like you’re going to hit your control total for this year, then there may be extra pots of money that become available.”
Earlier this month, NHSE’s chief financial officer Julian Kelly admitted ICSs are likely to end the year at least £500m in deficit, although the actual year-to-date position suggests the deficit could be higher than £1bn.
Coventry and Warwickshire, which according to board papers is reviewing its year-end forecast, said there were “national [and] regional incentives for ICBs if the current position is held”.
A report to the Kent and Medway ICS board said hitting a stretch target set by NHSE would “unlock” £10m to reduce its final deficit.
No Elective Recovery Fund clawback this year, NHSE confirms
Systems have also been told to assume they will not face penalties for missing activity targets in the second half of 2022-23.
NHSE has now said systems will be able to keep cash in the second half of the year, though local commissioning boards can still “clawback” money from trusts that are under-performing.
Original plans for the ERF would have seen systems that did not deliver enough activity lose funding.
This was suspended in the first half of the year as many areas struggled to hit the goal of treating 10 per cent more patients than they did before the pandemic as they faced higher than anticipated levels of covid and staff absence.
Services are working hard to make the best use of the money made available as part of the Elective Recovery Plan and despite significant demand across NHS services this winter, the NHS continues to make good progress toward the aim of virtually eliminating the number of patients waiting 78 weeks for care and treatment by April.