September 2019 | Healthcare Financial Management Association www.hfma.org.uk Modernising NHS procurement News Comment Features Features Professional lives Lack of capital Oversight framework: Diversity: efforts to Mental health: how Technical, events, undermines plans first moves towards make NHS finance to get the data right training, association to transform NHS system focus more inclusive to deliver plan news, job moves healthcare finance September 2019 | Healthcare Financial Management Association www.hfma.org.uk Modernising NHS procurement ContentsSeptember 2019 News Comment Features Features Professional lives Lack of capital Oversight framework: Diversity: efforts to Mental health: how Technical, events, undermines plans first moves towards make NHS finance to get the data right training, association to transform NHS system focus more inclusive to deliver plan news, job moves Managing editor News Mark Knight 0117 929 4789 [email protected] 03 News Editor Fears over impact of capital Steve Brown 015394 88630 constraints on patients [email protected] Associate editor 06 News review Seamus Ward 0113 2675855 A new government, Brexit and [email protected] finance pessimism Professional lives Yuliya Kosharevska 0117 938 8440 08 News analysis yuliya.kosharevska@ Taxing problem: how will the hfma.org.uk government appease clinicians’ Advertising Paul Momber anger over pension tax rules? 0117 938 8972 [email protected] Subscriptions Comment and membership James Fenwick 0117 938 8992 [email protected] Seeing the positives Production 10 Wheal Associates HFMA president Bill Gregory on 020 8694 9412 recent glimmers of good news [email protected] Printer BCQ Group 10 Steps towards system oversight NHS is moving towards system regulation, says Steve Brown Page 20 Achieving the right focus: management HFMA information will play a key role in delivering the 1 Temple Way, long-term plan’s mental health service promises Bristol BS2 0BU Professional lives Executive team Mark Knight Chief executive Features [email protected] 23 Technical Emma Knowles Capital funding back in the Policy and research director spotlight, plus news round-up [email protected] 13 Balancing up Alison Myles and NICE update Education director NHS finance has started taking action to put behind it a poor [email protected] 26 Development track record on diversity and is taking steps to ensure it is Ian Turner Bitesize training from the HFMA more equal and inclusive Finance director [email protected] and latest FFF developments 16 Modernising move Editorial policy The statements and opinions 27HFMA diary Six months on from the in Healthcare Finance are those of the authors and not Full listing of forthcoming events launch of a central procurement necessarily those of HFMA. scheme, we examine how it No part of this publication may be reported, stored in a 28 My HFMA has progressed and how the retrieval system or transmitted Mark Knight looks ahead, NHS is responding in any form by any means without permission.Healthcare plus member news and West Financial Management Association (HFMA) is a Midlands Branch in focus 30 HFMA key supporters registered charity in England Members honoured at an and Wales, no 1114463 and Scotland, no SCO41994. HFMA 32 Obituary awards ceremony this summer is also a limited company registered in England and In memory of Tony Waite Wales, no 5787972. 13 ISSN 1472-3379 healthcare finance | September 2019 01 news News Capital constraints pose risk “Government to safety and transformation support needs to be translated into urgent By Seamus Ward deliver on the prime minister’s priorities, action because the also about the including health. But it added that Mr risk to patients is availability of Eight in 10 trust leaders in England believe Javid’s announcement would focus on rising every day” capital funding. the current restrictions on capital funding are revenue spending – capital budgets are Chris Hopson, NHS Not all bodies have putting patients at risk and could undermine already in place for 2020/21, it said. Providers internally generated plans to transform the health service, according However, the government has already revised resources to fund capital to NHS Providers. capital funding since Boris Johnson took power projects or the freedom to In a survey, 82% of chief executives and chief in July. In one of his first policy announcements, use them. Many also point at the complexity of finance officers said the limited availability of the prime minister pledged £1.85bn in capital the system for managing capital, which often capital was posing a medium or high risk to for the NHS – £1bn was allocated as a one-off involves bidding for separate pots of funding. patient safety. Almost all of those surveyed capital boost for 2019/20, with the remaining In its 2018 briefing, NHS capital – a system in (97%) said capital constraints were hampering £850m to be spent on 20 capital projects. distress, the HFMA called for a simplification of the delivery of transformed services, as set out in NHS Providers insisted this funding could the system that allows NHS organisations access the NHS long-term plan. The survey received 200 only be considered a first downpayment on the to capital and for the process to be made more responses from 143 trusts. funding required. It called on the government to transparent. NHS Providers called on the government set out a multi-year capital settlement; commit NHS Providers chief executive Chris Hopson to address the issue of capital funding in the to bringing NHS capital budgets up to levels in said a capital funding settlement was needed to forthcoming spending round. comparable countries; and establish an efficient, rebuild the NHS. He highlighted the impact of The NHS had been waiting for the outcome of effective mechanism for prioritising, accessing capital constraints, citing the A&E department the spending review to receive news on capital and spending NHS capital based on need. at Kettering General Hospital NHS Foundation funding over the next five years. However, with Next year, 2020/21, is the final year of the 2015 Trust, which was seeing three times more the uncertainty over Brexit, the Treasury decided spending review period and figures for the final patients than its intended capacity. This was to limit the review to a single year – 2020/21 – year are often revised in a new spending review. compromising care, NHS Providers said. with a multi-year review to take place in 2020. According to the last Budget, the overall capital Mr Hopson added: ‘We know the government Chancellor Sajid Javid was due to announce available to health (the capital departmental shares our aim of a properly funded, well- the results of the one-year spending round on expenditure limit) in 2020/21 – before the recent designed system of capital funding, but this 4 September, but as Healthcare Finance went to boost in funding – was due to be £6.8bn. support needs to be translated into urgent action press, it was unclear what would be announced. HFMA members are not only concerned because the risk to patients is rising every day.’ The Treasury said the spending round would about the overall limit on capital spending, but • See technical news, page 23 Oversight framework moves to greater system focus NHS England and NHS NHS Improvement a merged set of metrics Providers’ director of policy and Improvement have released and NHS England in from the previous strategy, welcomed the moves details of a joint approach relation to providers assessment as providers were concerned to overseeing organisational and commissioners frameworks – regulation was not keeping pace performance in 2019/20 ahead are unchanged, the though more with developments. of introducing a new integrated framework will have regular engagement ‘This framework should help approach from next year. a greater emphasis on will be triggered where to support collaboration,’ she The NHS oversight framework system performance. Where necessary. said. ‘But much will depend replaces the separate provider possible, problems will be Proposals for a new oversight on ways of working and single oversight framework and tackled by ‘working with and framework for 2020 onwards the development of positive clinical commissioning group through system leaders’ with will be worked on during the relationships, particularly improvement and assessment greater autonomy for systems year, focusing on the balance between frontline organisations, framework. It will be used to with a track record of success. between organisational and system leaders and NHS identify support needs. Quarterly system review system oversight and how England/NHS Improvement’s Although the existing statutory meetings will be at the heart of system maturity affects this. new regional teams.’ roles and responsibilities of the new system, with a focus on Miriam Deakin (pictured), NHS • See comment, page 10 healthcare finance | September 2019 03 news Report says five-year plans will make mental health funding more transparent By Seamus Ward HFMA offers support to improve NCC Local systems will be required to show in their The HFMA has highlighted issues that need to be addressed in the national cost five-year plans how they intend to meet the NHS collection (NCC) following feedback from costing practitioners. pledge to increase mental health funding at a This summer acute trusts took part in the first mandatory submission of patient-level faster rate than overall funding growth. cost data, using new costing standards and guidance. Following a survey of costing TheNHS long-term plan announced a ring- practitioners, the HFMA has written to NHS England and NHS Improvement director of fenced fund for mental healthcare of at least pricing and costing Chris Walters to offer support to improve the process for next year. £2.3bn a year in real terms by 2023/24. It pledged Practitioners raised concerns in a number of areas, including the standards and that mental health funding will grow faster guidance, the collection process and the impact on costing teams.