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Delivery of over 70% of NHS priority programmes at risk

Over 70% of NHS England’s portfolio of priorities and programmes are rated as either ‘amber’ or ‘red’ for delivery confidence, the organisation’s board has revealed.

Of the 35 programmes outlined for this Parliament, 25 are under threat, with four having an even lower rating than previously: primary care, the primary care transformation fund, open data and transparency goals, and patient and public participation.

National director for transformation and corporate operations Karen Wheeler and interim national director for commissioning operations Richard Barker say that while good progress is being made across several primary care programmes, the poor delivery confidence “reflects challenges in both implementation of the infrastructure fund programme and finalising the GMS (general medical services) contract”, which also involves the Department of Health. Mitigations are being considered and contract negotiations are ongoing.

Within diabetes ambitions, also marked as amber/red, NHS England said its delivery confidence was affected by the process to procure the first wave of the national diabetes programme. The programme, created in August, is due for nationwide roll-out this year, with up to five million at-risk people expected to participate in a prevention effort.

NHS England said the problematic procurement process has now started, however, and action is being taken with Public Health England to mitigate existing delivery risks.

Learning disabilities also continue to be under threat, with no change to its amber/red status since the last reporting period. NHS England blamed this on the “complexity and scale” of the transformation required to the service, with progress now being made following the publication of the ‘Building the right support’ national plan. Transforming Care Partnerships are being supported to formulate and implement their joint transformation plans.

When NHS England set out these plans in October, it said 49 new partnerships would be working with people with experience of learning disability services by April this year to agree implementation plans, which will be delivered over the next three years.

Other risks still remain across science and innovation and patient and public participation ambitions, with the former owed to delivering genomics samples targets and the latter blamed on the work needed to deliver the commitments of the emerging self-care programme and the next phase of NHS Citizen.

Several red risks are also currently being managed through the ‘corporate risk register’, according to the national body. At the top of these is urgent care, for which “robust winter planning arrangements” are already in place, including initiatives with the private and voluntary sectors.

All System Resilience Groups have also detailed their winter capacity plans, with NHS England supporting tripartite members to reduce risks of trusts failing A&E standards once again. The organisation intends to bring urgent care from the red to amber/red by March.

The national body also reiterated its goal to hire an extra 10,000 staff for the red-rated general practice by 2020, with work being undertaken alongside Health Education England to build the capacity and capability of the workforce. Better ratings are expected by September.

Similar mitigation work is being carried out to ensure the Five Year Forward View implementation doesn’t fall through, to secure the capability of the Cancer Drugs Fund (currently undergoing consultation), and of commissioning support services (with commissioning support units currently at risk of becoming financially and commercially unviable).

The programmes currently rated as ‘green’ for maximum delivery confidence are the Healthy New Towns programme and the personal health budgets scheme.

(Top image C. Peter Byrne, PA Wire)


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