In a letter sent to providers in around 14 “capped expenditure” areas today, NHS Improvement said organisations should not be considering plans that would breach patients’ constitutional rights over elective care, and will need to ensure that patient safety and service quality are maintained.
As previously reported by HSJ, some of these areas have considered whether to systematically draw out waiting times for planned care, including explicit consideration of breaching the 18 week waiting standard, and limiting patients’ ability to opt for non-NHS providers. Other options have included cutting staffing levels and closing or downgrading services.
These plans were drawn up in response to instructions sent out in April by NHSI and NHS England, which warned the areas they had been “living off bailouts from other parts of the country” and would now need to take “difficult choices” to stay within a combined funding envelope for their area.
The previous instructions did not state constitutional standards over waiting times and patient choice would need to be maintained.
HSJ understands the capped expenditure process initially aimed to close a financial gap of £470m, which was the distance between the financial plans and targets of providers within the 14 areas. However, proposals drawn up locally indicated potential savings of £250m, with significant concerns about the risks involved in delivering these.
It is understood that national leaders have now agreed to focus on delivering £250m, instead of pushing to get closer to £470m.
Article from The Health Service Journal, 27 June 2017.