First three troubled areas to be put into 'success regime'

The areas are:

• north Cumbria;
• Essex; and
• northern, eastern and western Devon.

Mr Stevens was speaking at the NHS Confederation conference in Liverpool this afternoon.

The areas all have serious financial problems and some major care quality and performance issues.

The new policy is expected to see the organisations in these areas receive coordinated, and more direct, intervention and support from NHS England, Monitor and the NHS Trust Development Authority.

HSJ had previously reported that North Cumbria, Essex and Kent had been under consideration to be put in the regime. Kent is currently not being placed in the regime, it was confirmed today.

Mr Stevens said services in these areas would need to redesign clinical models, and referred to greater connections between district general hospitals and tertiary providers.

A document published today on the regime said: “The problems in these health and care economies are often deep rooted, longstanding, and spread across the whole system as opposed to individual organisations. Local and national organisations may have worked hard for some time to improve services for patients and the public, but not made the required progress.

“Transformation is therefore now required, and this will only be achieved if national and local leaders take a different approach to those taken previously, which have not yet delivered the expected improvements for patients and the public.”

When the NHS England chief executive first proposed a “success regime”, at the HSJ Annual Lecture in December, he said NHS England, Monitor and the NHS Trust Development Authority will be “directive in terms of the support that will be provided” – indicating the areas will be instructed where necessary on what changes need to be made. The approach would bring “the regulatory, the funding flexibility [and] the conditionality to chart a course for these places”, he said.

Mr Stevens today reiterated a strong message about the need for the NHS to quickly make large efficiency savings, as outlined in an interview with HSJ ahead of the conference.

He said: “I have to say I see no likelihood that the NHS will receive additional injections of cash this year. That’s going to require a huge team effort.” This is despite a number of experts and sector figures predicting an increase in the overall NHS 2015-16 revenue budget will be needed.

He confirmed, as reported by HSJ this morning, the national NHS bodies, working with representative bodies including NHS Confederation, would engage with NHS leaders over the next four months about how to make large efficiency savings in the coming four years.

Mr Stevens said the output from this would be used, along with findings of Lord Carter’s procurement and efficiency review, and “converging with the work going on behind the scenes on the spending review”. This will mean, in the autumn, “the big building blocks on [how to improve] efficiency will be sitting in front of us”.

However, he said: “I’m not denying we have quite a few well worked up hypotheses about where things can be done.”