The Commissioner Sustainability Fund (CSF) will be reduced as of this year, with the aim of eventually phasing it out, NHS England has said.
The decision to reduce the amount of money available to CCGs is in line with NHS England’s expectations that CCGs will be able ‘to balance their financial position each year without additional support’, according to the 2019/20 Operational Planning and Contracting Guidance, published on 10 January.
The guidance said: ‘The CSF will be phased out. We are taking the first step towards this in 2019/20 by reducing the CSF from £400m to £300m. CCGs will be expected to plan against financial control totals communicated during the planning process.’
The fund was introduced in 2018/19 ‘to support those CCGs that would otherwise be unable to live within their means to achieve in year financial balance’.
Strings attached
However, in order to be able to access the fund, CCGs have to show they meet a set ‘control total’ target, which is a financial target tailored to each CCG.
The CSF contributions are ‘paid quarterly in arrears as long as the CCG has achieved its financial control total for the quarter’, according to the Commissioner Sustainability Fund and financial control totals for 2018/19: guidance.
A spokesperson from NHS CC told Healthcare Leader they cannot see how a reduction in CSF could cause any major issues, as CCGs have been allocated additional money that comes without conditions before CCGs can use it.
Last week, CCGs were allocated £570bn over the next five years to implement the long term plan, and are set to see a cash increase of at least 4.4% next year, rising to a minimum of 17% by 2023/24.
NHS England said that the allocations were made through an improved funding formula that takes into consideration the most deprived areas and the needs of their population.
Delivering efficiency
In November 2018, CCGs were asked to cut their administrative costs by 20% to maximise the funds available for direct patient care.
In a briefing on the NHS Planning Guidance 2019/20, the BMA said it remains concerned by the possibility that a portion of the additional money invested in the NHS will be used to reduce deficits.
It said: ‘The measures included in this planning guidance provide little reassurance. There is no indication that the underlying causes of CCG deficits have been solved. Therefore, it is unclear what the removal of the CSF will achieve.’
The BMA suggested that CCGs might be able to reduce costs by merging and that ‘the fact that the guidance asks CCGs to propose new approaches to “efficiencies” may be leading them towards making this decision’.
