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Five things we learned at NHS England’s board meeting

Five things we learned at NHS England’s board meeting

NHS England held its September board meeting today. Here are few things to come out of the meeting
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NHS England held its September board meeting today. Here are few things to come out of the meeting.

1. CCG budgets are on the same track as they were last year

The level of risk against CCG budgets so far this year is at the same level as it was last year at £370m.

Paul Baumann, NHS England’s chief financial officer, told the board that that the balance position consists of £520m of net risk across 92 of the 207 CCGs ‘offset by a couple of potential additional underspends that we've managed to identify in central budgets’.

He told the board that the financial position reflects two issues.

The first is that hospital activity has seen ‘a significant rise in the cost per case’.

The second is that CCGs are producing ‘an unprecedented level of efficiencies’ this year. He said the CCGs are expecting to deliver £2.9bn in efficiency savings compared to just under £2bn last year.

Mr Baumann told the board the savings are from ‘transformational programs related to Five Year Forward View rather than more transactional savings’.

However, he also said the current financial risk ‘feels very real’ as last year the overspend grew to almost £600m by the end of the year.

2. ‘Past performance is not a good predictor of future success’

David Roberts, non-executive director for NHS England, ended the financial recap on what was later described by Professor Sir Malcolm Grant as a ‘sobering note’.

He told the board, ‘past performance is not a good predictor of future success’, adding ‘this year is materially harder. The pressures are higher, the room for error is higher and the room for compensating actions is less’.

He added: ‘Whilst I think we came away with a degree of confidence as always that the team are doing the right things where addressing the right challenges, I really think the board should be aware that you should not take huge confidence from having done this in previous years.’

3. A&E streaming is ‘not a long term solution’

Pauline Philip, national urgent and emergency care director, told the board that the A&E streaming scheme, first announced in the Spring budget this year, is an ‘interim solution’ until NHS 111 service is improved.

She said A&Es are seeing a ‘significant number’ of patients come in with minor illnesses, adding that the ‘best solution’ was to have every A&E ‘linked’ with a co-located GP service.

She said: ‘This is not a long-term solution and we wouldn't wish it to be but we think it's very important as an interim solution until we arrive at the appropriate delivery point on our 111 services.’

4. The hunt is on for the next national medical director

Sir Malcolm Grant told the board that the job advertisement is out for the next national medical director with the aim of appointing Bruce Keogh’s successor before the next board meeting.

The job advert says the successful applicant will ‘drive and oversee system-wide learning and improvement to address both short-term and longer term issues surrounding patient care and quality as well as supporting the transformation agenda’.

5. Attendees had a lot of praise for STPs

STPs took a backseat at the meeting but Matthew Swindells, NHS England's national director for operations and information, briefly highlighted the ‘progress that's being made’ with STPs ‘right across the country’. He said there has been increasingly more collaboration ‘between different parts of the NHS and NHS and social care to solve local problems’. However, he added that it’s ‘not to say that everywhere it's easy’.

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