NHSE asks ICSs to complete “rapid two-week exercise” to address financial challenges created by industrial action

NHS England has written to ICBs and trusts, asking them to complete a “rapid two-week exercise” to address the financial challenges created by industrial action, and agree actions required to deliver priorities for the rest of the financial year.

The letter outlines agreed priorities including achieving financial balance, protecting patient safety, prioritising emergency performance and capacity, whilst protecting urgent and “high priority” elective and cancer care.

Following on from NHS funding “increasing in real terms” between 2019/20 and 2023/24 to over £160 billion, the letter reflects on the request for ICSs to set “ambitious plans” in accordance with pressures facing the healthcare system. These plans, the letter further highlights, were set on the basis that there would not be any significant ongoing industrial action.

With the impact of more than 40 days of industrial action across the financial year being estimated at £1 billion, the letter shares actions agreed with the government to cover costs. These include the allocation of £800 million to systems from the reprioritisation of national budgets and new funding, and the reduction of the elective activity target to 103 percent, with systems allocated their full ERF funding.

The job of ICBs is to agree steps to “live within their re-baselined system allocation and reflecting the impact of the reduced elective activity goal”, with protecting patient safety as the foundation. Delivery on capacity, including beds and ambulance services, are “expected to be fully implemented without further delay”.

Systems will be required to show how they have worked out efficiency plans to include reductions in agency staffing, to demonstrate where they need flexibility for programme funding, and to create an elective plan “driving productivity from core capacity”.

Sessions will be scheduled for each individual ICB Executive and their provider colleagues from 27 November to agree on proposed actions.

The letter is signed by Julian Kelly, chief financial officer, NHS England; Dame Emily Lawson DBE, interim chief operating officer, NHS England; Professor Sit Stephen Powis, national medical director, NHS England; and Dame Ruth May, chief nursing officer, England.

To read the letter in full, please click here.

We’ve been looking into how different NHS organisations are tackling key topics – click here to read how ICSs in Manchester, Dorset and London are approaching health inequalities, or here to read how mental health is being tackled at national, ICS and trust level.