NHS leaders call for financial targets to be scrapped ahead of covid-19 surge

Sarah-Jane Marsh, chief executive of the Birmingham Women’s and Children’s Foundation Trust, said removing all cost improvement plan requirements for trusts would be “one of the best things the government could do for the NHS now”.

She told HSJ: “It takes a lot of time and co-ordination to get together and deliver on the [cost improvement plans]. Some of the people who would be doing this work absolutely need to be working on a response to coronavirus.

“It’s completely unrealistic to think about how we can make workforce reductions and workforce savings [given the expected coronavirus demand]. If we stood [the CIP requirements] down now we can make a better use of everyone’s time.

“We have to be 100 per cent focussed on clinical need.”

NHS Providers, which represents trust leaders, agreed that NHS England and NHS Improvement need to revisit trust and system financial targets for 2020-21.

HSJ has asked NHS regulators and the Department of Health and Social Care to respond. In the Budget earlier this week, chancellor Rishi Sunak said a £5bn contingency fund would be set for the NHS to respond to the outbreak, adding this could rise further still if required.

It is not yet clear how this will be deployed, and whether it could enable financial targets to be relaxed.

Ms Marsh, who also chairs NHS England’s maternity and children and young people’s transformation programmes, said trusts will have “no time” to work on CIPs to meet their own financial targets, due to their efforts in responding to covid-19.

She said on Twitter: “We have no time to focus on (the requirements, and) any workforce schemes will be undoable, and by the time we are through covid-19 winter will be approaching.”

Tracy Allen, chief executive of Derby Community Health Services FT, agreed that efficiency targets should be relaxed. She tweeted: “We’re putting unnecessary stress on people trying to carry on with a parallel universe of business as usual 20/21 planning.”

NHS Providers chief executive Chris Hopson said NHS finances will be “significantly affected” by coronavirus.

He said: “NHSE/I will need to revisit trust and system 2020-21 financial trajectories once we can properly assess the impact of inevitable changes like loss of elective surgery income, increased staffing costs and delayed cost improvement programme savings, as senior leaders rightly focus on coping with an unprecedented operational challenge.”

Many trusts and systems were already struggling to draw up realistic plans to meet their financial targets for 2020-21, even before the outbreak.

At the time of writing, there have been 596 confirmed coronavirus cases in the UK and 10 deaths. Sir Patrick Vallance, the government’s chief scientific adviser, has warned between 5,000 and 10,000 Britons could be infected.

There have also been calls for the Care Quality Commission to suspend inspections while staff deal with increasing covid-19 patients. The CQC, however, said inspections would continue but would take a “pragmatic” approach.