“The floggings will continue until morale improves” appears to be NHS England’s management approach as they turn up the heat on Integrated Care Boards and NHS trusts in their efforts to squeeze down a collective deficit projected as £3 billion.
They will have been encouraged to crack the whip by Health and Social Care Secretary Wes Streeting’s declaration of “total confidence” in NHSE chief executive Amanda Pritchard just days before the election.
However their efforts to squeeze down spending to the tight limit set by Tory Chancellor Hunt are taking place despite the warnings from think tanks that the level of spending is simply set too low for the new government to be able to deliver on its promises, and will inevitably lead to a decline rather than a revival..
Streeting’s endorsement came after NHSE issued new guidance at the end of May which demanded local Integrated Care Systems (ICSs) “must live within its government-mandated spending limits”.
The guidance incorporates a new, perverse incentive system, which penalises the most financially-challenged ICSs that have not been able to set or stick to a balanced budget, by cutting their allocation of capital for maintenance and renewal of buildings and equipment by up to 10 per cent. The same scheme offers rewards of extra capital for those that are already able to cope within their budgets.
Full story in The Lowdown, 22 July 2024