Daily Insight: An ending to the spending

When NHS England’s chief finance officer Julian Kelly announced back in May that integrated care systems would get an extra £1.5bn to plug budget gaps caused by spiralling inflation, it came with strings attached.

The cash didn’t cover all of the rising costs so systems were told to make up the difference with another round of savings – or face additional restrictions from NHSE.

From NHSE’s point of view, this was largely successful, even if some ICSs are relying on delivering unprecedented levels of savings to bridge the gap. But it emerged last week that five of the 42 ICSs submitted deficits adding up to around £100m, despite edicts from head office stating they had a “new joint legal duty” to break even. 

HSJ has identified four of the five ICSs: Devon, Shropshire, Nottinghamshire and Herefordshire and Worcestershire. NHSE confirmed to HSJ that these areas will still be required to close the deficit during the year – and could now place “additional restrictions” on spending at deficit ICSs, including on capital budgets.

The cavalry are on the way (ish)

The good news is a contract has been signed for providing surge capacity for ambulance services. The bad news is this isn’t quite true. Or it’s a premature announcement. Or something.

HSJ yesterday pointed out that health minister Maria Caulfield’s statement on the support for the embattled ambulance services may have given the impression that the deal was done, except it wasn’t. The contract had not yet been awarded, we discovered.

Ms Caulfield told MPs: “We have procured a contract with a total value of £30m for an auxiliary ambulance service, which will provide national surge capacity if needed to support the ambulance response during periods of increased pressure. That capacity is there, should we need it.”

However, NHSE, which advertised the contract in May, confirmed to HSJ that the contract “is yet to be awarded”.

Ms Caulfield also told the Commons she would be meeting all 11 ambulance trusts “over the coming days to make sure that they have the capacity and the resilience they need not just to deal with the pressures now, including with the warm weather, but to prepare for the forthcoming winter pressures that we know are inevitable”.

There are also doubts about two other points made by Ms Caulfield in Parliament in a debate about the current high pressure on ambulance services. Read our story here for the full details.