17.12.15
NHS England confirms allocation shake-up in 2016-17 plans
Changes to resource allocations to providers and the commissioning sector for 2106-17 until the end of the decade will ensure greater equity across CCGs, faster progress with NHS strategic goals and stronger long-term collaboration, NHS England has said.
In its board meeting papers for a meeting held today (17 December), NHS England said no CCG will be more than 5% under target for their commissioned services in the next financial year. All CCGs will receive a minimum cash growth equal to real-terms growth, plus specific non-routine policy pressures – predominantly linked to pensions and seven-day services – unless the commissioning body is 10% above target.
In NHS England’s new mandate for 2016-17, it said it will publish the results of the CCG assessment framework for 2015-16 by June, which will provide CCGs with an “aggregated Ofsted-style assessment” of their performance. This would allow them to benchmark against other commissioning bodies and determine whether national intervention is needed.
The new Ofsted-style CCG framework for next year will include metrics to measure progress on NHS planning guidance priorities, including overall assessments for each cancer, dementia, maternity, mental health, learning disabilities and diabetes – as well as metrics on efficiency, core performance, technology and prevention.
By the end of the first quarter in 206-17, NHS England will publish the first overall assessment for each of these six clinical areas.
A new ‘inequalities adjustments’ for specialised care and “more sensitive adjustments” for CCGs and primary care will be brought in, alongside a new ‘sparsity adjustment’ to ensure closer alignment with population need in remote areas.
To accelerate progress in NHS England’s strategic targets, it will up the funding growth for GP services and mental health and introduce a £1.8bn ‘sustainability and transformation fund’ with a focus in 2016-17 on “restabilising the NHS and a priority in subsequent years of accelerating transformational investment”.
Commissioners and providers will be asked to integrate strategic planning to stimulate and strengthen long-term collaboration between them. There will also be opportunities to pilot shared financial control totals.
As he previously revealed in an HFMA annual conference last week, attended by NHE, NHS England’s chief financial officer, Paul Baumann, said the body will move to multi-year allocations in the form of three-year firm allocations and two-year indicative allocations to help providers plan ahead.
“However, NHS England will reserve the right to change firm allocations in a number of specific circumstances where the financial stability of the commissioning system is challenged or it is clear that the allocations are no longer fair in their distribution to health economies,” Baumann added.
“To mitigate this, NHS England needs to be clear to all parts of the commissioning system the circumstances under which the allocations will be reviewed.”
Examples of these include a disproportionate financial imbalance in any part of the commissioning system, a new government policy with extra funding creating an additional pressure in one area, or an uneven increase or decrease in the share of the national population.
Changes to firm allocations may also be sparked by national contracts or pay award that requires extra funding or resource redistribution, or any other change in mandate funding, Baumann said.
Allocations could potentially come under review if there is a need to ensure minimum contractual growth to GP practices through primary care allocations, and in the light of changes to the payment currencies which may move funding pressures between commissioning streams – such as a move to HRG4+, although this has been deferred until 2017-18.