NHS England pushes for more private capacity and cancels planning round

As reported yesterday by HSJ, the terms of the current three-month national contract with 14 independent providers only give the NHS access to the same capacity that it used in October and November, when covid pressures were far less severe.

This has resulted in some hospitals not being able to access the additional capacity they need. However, national leaders now appear ready to trigger “surge” arrangements under the contract, which would provide full access. 

Higher activity levels in the private sector would trigger additional payments. It is understood the Treasury has close oversight over the national private sector contracts, particularly since it emerged much of the purchased capacity was unused over the summer.

In a bulletin to providers yesterday, chief operating officer Amanda Pritchard also said: 

• The annual NHS finance and operational planning rounds would be delayed to quarter one of next year, due to “relentless pressure” on trusts, with current rules rolled over into 2021-22.
• The CQC will be “minimising their asks of trusts” — trust leaders were told it would require the approval the chief inspectors

She wrote: “Please do make use of the independent sector – they have agreed to provide a guaranteed level of activity, and within contract we can surge and use 100 per cent of their capacity.

“We’re now asking each integrated care system, via their regional team, to propose a surge plan and identify a trust CEO lead accountable for the system plan covering the next six weeks in the first instance. These surge plans should be in place by 22 January.”

It appears the surge provisions have not so far been triggered.

Ms Pritchard also wrote of the pressures more generally: “Please continue to create surge capacity to accept and manage patients with covid, including the ability to provide additional critical care from within the region and to support cross-regional mutual aid. Our regional teams will work with you on this.

“Protect capacity for Priority 1 and P2 patients and combine waiting lists across systems. P3 and P4 treatments can continue if there is no unmet demand within the region or support being asked from another region that could benefit from release of these assets….

“In moving to these surge arrangements, I know we are asking you and your teams to dig deep once more. This will be the toughest part of the pandemic response.”

This story was amended at 15:57 with correction to CQC’s process.