14th November - 26th November

Healthcare leaders outline their priorities for the impending government, which present opportunities for industry
In the wake of the impending election, key healthcare organisations have published their considerations for the new government to take into account. The recommendations highlight the current pressures facing the NHS, as well as signalling future changes that may impact current operations. Industry should take note of the recommendations as they represent opportunities for industry to take a leading role in supporting the needs and requirements of the NHS.

There have also been increasing concerns over medicine shortages; the latest prescribing figures show diabetes medicines are dominating prescribing spend; and digital health providers, GP at Hand, are reported to have the third largest patient list in England which will make it an increasingly important stakeholder for industry.

Strain upon NHS services brought to the fore
Healthcare leaders have outlined the most critical priorities for the new government to address through a survey undertaken by the NHS Confederation.

The diminishing workforce, a need for urgent social care reform and capital investment have been highlighted as critical issues. Of those surveyed:

  • 98% said the worsening social care crisis is having a knock-on impact across the NHS.
  • 90% claimed that understaffing was putting patient safety and care at risk.
  • 84% said that improving care for people with mental health issues is a critical.
  • 65% agreed that the NHS does not need another top-down reorganisation like the Health and Social Care Act 2012, which suggests they support the direction of the NHS Long Term Plan.
  • 58% believe this winter will be the worst on record for waiting times and performance across the NHS.

The latest NHS performance statistics support the concerns of NHS leaders, with key targets such as the four-hour treatment target, hitting their worst levels since the standards were introduced in 2004.

The figures published by NHS England showed that hospitals missed a series of key targets, including patient waiting times for cancer care and non-urgent operations, such as cataract removals, hernia repairs, and hip and knee replacements.

From a target of 95%, only 83.6% of people seeking help in A&E were treated within the four-hour target, which is the lowest percentage since records began. Furthermore, out of 119 hospitals with major A&E departments, only two met the 95% target in October. The number of people waiting to start treatments has also reached 4.6m – a 5.7% year-on-year increase.

Industry has an important role in helping to reduce pressures on healthcare services, by providing products that can support care in the community and aid speedier discharges. The need to reduce pressures on secondary care will also mean that stakeholders, such as primary care networks, will become increasingly important stakeholders for industry as they take on an increasing number of secondary care services.

See also: Finance in the NHS course
Learn the basics of NHS finance, from who makes the decisions through to how the money is spent.











IT procurement called into question
Respondents to an NHS Confederation survey were asked what their priority areas would be for long-term capital investment, with 45% voting for IT infrastructure and 36% selecting buildings as critical areas.

Upgrading IT equipment has been a key focus for the NHS. However, a study by technology service provider, Proband, has revealed that the NHS is paying almost four times the recommended mark-up for IT products. Over a two-year period, the analysis found that the average margin paid by the NHS was 12.78%.

Measures are being taken to reform the NHS Supply Chain and simplify the procurement landscape in a bid to achieve best value from their purchases. Industry can also play an important role in helping the best spending decisions to be taken, by leveraging their trusted relationships with providers and commercial acumen to support the best spending decisions to be made within the NHS. This will become increasingly important as industry provides an increasingly digital service offering alongside their tradition products, such as apps and monitoring equipment.

See also: Competition and Procurement Course
Know the legal requirements that apply specifically to your professional activities, such as competition law, procurement and public contracts regulations.




Manifesto for medicine published by the ABPI
The Association of the British Pharmaceutical Industry (ABPI) has launched its own General Election 2020 Manifesto for Medicine, which sets out a series of recommendations for the impending Government to implement in order to position the UK as a world leader in the research and development of new medicines.

Amongst the recommendations are:

  • For the National Institute for Health and Care Excellence’s (NICE) baseline cost effectiveness thresholds, which have not been updated for over 20 years, to be restructured so that they can be applied more flexibly reflect the full impact of new medicines on patients, carers, the NHS and society.
  • Increasing R&D investment to 2.4% of GDP by 2027, and up to 3% in the longer term.
  • Creating a new life sciences skills fund to help address skills gaps for UK science in areas such as genomics, immunology and bioinformatics.
  • Committing to ‘gold standard’ IP protection to attract global investment.
  • Implementing a new vaccines strategy to improve uptake, tackling antimicrobial resistance and ensuring the UK is a world-leader in immunisation.

NHS England has also launched a consultation on the NHS Commercial Framework for medicines, which aims to establish how NHS England, NICE and the pharmaceutical industry will work together to support the introduction of clinically and cost-effective treatments.

Industry has until 10 January 2020 to respond to the framework, which:

  • Outlines the principles on which NHS commercial medicines activity will be based.
  • Defines the roles and responsibilities of those involved in commercial medicines activity.
  • Details how pharmaceutical companies can engage with the NHS.

Industry should keep an eye on these developments, particularly changes to the role of NICE and the medicines commercial framework as they will have a big impact upon how medicines are taken up within the NHS.


Concerns over patient safety raised due to medicines shortages
Concerns over medicines shortages within the NHS have been increasing. In a leaked document seen by The Guardian, the Department of Health and Social Care (DHSC) is reported to have advised doctors to prioritise which patients can access lifesaving medications, in an attempt to ration short supplies.

According to The Guardian, the DHSC also suggested breaking tablets in half to increase numbers or finding prescribing alternatives. Yet healthcare practitioners say this could result in complications being experienced by patients and would require increased practitioner supervision which will put increasing demand on the NHS.

A spokeswoman for the Royal Pharmaceutical Society said: “A range of factors are responsible for shortages, such as manufacturing problems, global demand for medicines and fluctuations in the exchange rate. At the moment pharmacists are working incredibly hard to get the medicines patients need. Pharmacists spend hours tracking down stock and working together to help patients.”

The Pharmaceutical Services Negotiating Committee has published a table of the medicine shortages notified by DHSC and NHS England. Are patients struggling to access products within your clinical area? Can you support pharmacists? Or, do you have an alternative product that could be prescribed?


Latest prescribing figures show diabetes is dominating spend
The latest prescribing figures for the NHS reveal that during 2018-19 the total cost of drugs prescribed in primary care fell by almost £250m (2.8%) in 2018-19, but over the same period the cost of drugs prescribed in hospitals rose by 11.1%, accounting for £10.2bn or 53.7%.

Figures also revealed that 12.5% of the total cost of prescribing in primary care during 2018/19 was for the treatment of diabetes.

According to the data published by NHS Digital, in 2018/19, the net ingredient cost (NIC) of prescribing in primary care was £8.6m. Of this, £1.1m was allocated to drugs and devices used in diabetes, which is the highest cost of any individual section in the British National Formulary.

The NIC for drugs used in diabetes also rose from £599m in 2008-09 to £1.075bn in 2018-19, which is an increase of 79.3% in the past decade. The number of items of drugs used in diabetes also increased from 33m in 2008-09 to 55m in 2018-19, which is a rise of 68%.

The World Health Organisation (WHO) has announced plans to tackle the high costs of insulin in low- and middle-income countries. WHO said that they aim to encourage generic drug manufacturers to enter the market and increase competition in an attempt to drive down prices which have skyrocketed in recent years – what are the implications for industry?


Patient lists for digital providers are on the surge
Controversial digital primary care provider, GP at Hand now has the third largest registered patient list in England.

The app, which is available for patients in London and Birmingham, claims to enable patients to “see an NHS GP in minutes, for free”.

The findings demonstrate that ease of use, access and modern service delivery is high on patients’ agendas; and with plans to expand to more cities across England, GP at Hand will become an increasingly important stakeholder for industry to engage with.

In a bid to improve medicine compliance rates and achieve better outcomes for patients, Addenbrooke’s Hospital is piloting a programme that aims to educate patients and improve medicines adherence through virtual reality experiences.

The collaboration alongside Cognitant Group and supported by grants from UCB and Pfizer, demonstrates an appetite for innovative approaches to healthcare delivery that extends beyond treatment.

Industry has an important role to play in pushing the boundaries of what is possible and modernising its approach to service delivery in order to achieve the best outcomes for patients. Innovative approaches, such as this, could also help to increase your chance of product uptake within the NHS.



25 October - 13 November

NHS capital spending called into question
How the NHS spends its money has been called into question, with stories relating to the impending general election, the UK’s spend on capital when compared to other OECD countries and the amount of money that is spent on the top 5% users of primary and secondary care services. There is a clear desire to make the NHS a world-leading, tech-driven service, however, rhetoric is not always matching reality.


Politicians play ball with NHS in lead up to the general election
True to form, the NHS has become a political football in the run up to the general election. At one end of the pitch Labour have vowed to remove all traces of privatisation from within the NHS, while at the other end of the spectrum concerns have been raised that Conservative leader, Boris Johnson, is making plans to sign a trade deal with the US, which cynics say could result in the NHS drugs bill soaring.

An article published by PharmaPhorum highlights that while the full consequences of a trade deal can’t be known in advance, if the UK were to pay list prices that are closer to those in the US, the NHS’ drugs bill could skyrocket to £27bn a year. To put that into context, the UK’s annual drugs bill was £18bn in 2017/18. Having said this, confidential discounts and rebates are a feature of both the UK and US markets and so this figure could be contested.



UK invests significantly less in healthcare capital than other OECD countries, report finds
With Brexit looming, the government has worked hard to assert the NHS as a world-leading, tech-driven service. However, according to a report published by The Health Foundation, ambition does not currently match up reality.

The analysis suggests that the UK is investing significantly less in health care capital, which includes medical technology, equipment, machinery, buildings and IT, when compared to most countries with a similar GDP.

According to the report, for England to bring its overall funding in line with the average OECD country would require at least an extra £2.5bn extra every year on top of the existing budget for 2019/20.

The charity, which is “committed to bringing about better health and health care for people in the UK”, warned that this means the recent announcement of funding to upgrade hospitals will not be enough to bring the UK in line the spending of other OECD countries.



Funding boost for oncology provision 
Funding for technical innovations has been announced within the NHS, particularly within the field of oncology.

The 78 trusts that will benefit from funding for new cancer testing and detection technology have now been announced, following the Prime Minister vouching an extra £200m funding for new cancer screening equipment last month.

The trusts will receive funding over the next two years to replace, refurbish and upgrade CT and MRI scanners, breast screening imaging and assessment equipment.

Cancer Research UK has also announced a £56 million investment to create a new global hub that aims to accelerate the development of advanced radiotherapy techniques. Cancer Research UK RadNet will “pioneer” the use of the latest techniques such as FLASH radiotherapy and artificial intelligence.

NHS England and NHS Improvement have also published a proposal for implementing collaborative imaging networks on a national basis across England.

Currently, the NHS spends around £2bn per annum delivering imaging services within the NHS, which play an important role in treating and diagnosing conditions that range from cancer, heart disease, stroke and dementia.



Funding pledged for digital prescribing systems
The Government has pledged £26m to upgrade digital prescribing systems with the aim of raising efficiency, reducing prescribing errors and improving patient safety.

Using digital prescriptions reduces medication errors by 30% compared to paper systems, according to the Department of Health and Social Care.



More people to access personal health budgets
Up to 100,000 more people are set to benefit from personal health budgets (PHB) from 2 December, as the scheme expands to include everyone eligible for an NHS wheelchair and people who require aftercare services under section 117 of the Mental Health Act.

PHBs aim to provide patients with greater choice, flexibility and control over their health and care support. Currently over 70,000 people currently accessing the funding, but the NHS Long Term Plan set out an aim to increase this figure to 200,000 people by 2024.



Expenditure for high cost, high need patients is more for the NHS than all other patients, study reports
A report published by The Health Foundation has revealed that more money was spent overall for the top 5% of users of primary and secondary care services (£147m) than all other patients put together (£139m).

The analysis of health care use by high cost, high need patients in England found mean annual costs per patient were over 20 times higher in high-cost, high-need patients compared with all other patients (£9,789 vs £487).

While most of the difference was attributable to inpatient costs, the high-cost, high-need group also had higher attendances across all settings and higher prescriptions.

The report calls for greater investment in interventions that help to manage these patients in primary care and the community, which it says will help to reduce the need for unplanned and costly hospital admissions, whilst reducing costs and improving the quality of care. This represents opportunity for companies that have products and services that can support care provision out of hospital settings.

The high-cost, high-need group of patients outlined in the study were older, suffered from a higher-level morbidity and 55.9% had more than three conditions.

This week a House of Lords committee heard how these patients are being put at risk of being ‘poisoned’ by their medicines because they are being prescribed treatment for multiple diseases, yet not enough research has been done on interactions between drugs.

Speaking at a House of Lords’ science and technology committee, Sir Munir Pirmohamed, professor of molecular and clinical pharmacology at Liverpool University, said most of his patients are on more than 10 and often more than 20 drugs, which have only been tested in people who don’t have the multiple diseases.

He said that this means “we are often ‘poisoning’ the elderly because of the dosing that we are using”. What role does industry have to play in assuring patient safety when it comes to drug interactions?





Poorest communities impacted by cuts to public health spending
Analysis by the Institute for Public Policy Research has revealed that the poorest communities have been hit hardest by the £900m of cuts to public health spending, which could widen the already stark differentials in life expectancy between those in well-off and poor areas. The people in the poorest communities are more likely to develop and die from killer conditions such as cancer, lung disease, obesity, diabetes and liver disease.

According to the report, the most deprived areas have lost £120m in total, while the least deprived have seen their budgets contract by just £20m – this will impact uptake of vaccinations and other public health measures.



In other news…

NHS Providers publication aims to drive up standards in secondary care
NHS Providers has circulated its first in a new publication series that aims to demonstrate the work of NHS trusts and foundation trusts are doing to improve care for patients and service users.

Focusing on how trusts have responded to feedback from the Care Quality Commission (CQC), the report reveals that whereas in 2014, over half (68%) of trusts were rated ‘requires improvement’ or ‘inadequate’ by CQC, in 2019, the majority of trusts (59%) are now rated ‘good’ or ‘outstanding’.

The publications will provide useful information to people selling products into secondary care as it will use real world examples to highlight examples of good practise and demonstrate where improvements need to be made.

National medical director’s access standards given the green light
There has been an overwhelmingly positive response to new access standards for mental health services, cancer care, elective care and urgent and emergency care, which are currently being tested within the NHS.

NICE international relaunched
The National Institute for Health and Care Excellence (NICE) has announced plans to re-launch its international division, NICE International, to deal with a growing number of enquiries from overseas health and social care bodies.

Funding announced for global health research projects
The National Institute for Health Research has announced an investment of £34m into global health research projects to tackle epilepsy, infection-related cancers and severe stigmatising skin diseases in low- and middle-income countries.

Latest figures could impact requirement for products and services
Heart failure hospital admissions have increased by one third, GPs have reduced antibiotic use as the antimicrobial resistance threat grows, there has been an 80% rise in liver cancer deaths in UK and GP appointments surged by 2.7m in first half of 2019/20 – these statistics could impact requirement for your products and services.




9 October – 24 October

The Queen’s Speech signals a sign of things to come
The Queen’s Speech signals that key changes are on the horizon for the NHS and industry, with focus being placed upon speeding up access to new innovations, improving safety and removing elements of the Health and Social Care Act. The CQC has also advocated for investment in technology to improve technology and outcomes, however, experts have reported that in some cases clinicians are blocking access to treatments.

Forthcoming priorities for the NHS presented to Parliament
The Queen’s Speech was delivered on 14 October, setting out the government’s forthcoming priorities for Parliament to approve. 

The speech proposed several key pieces of legislation relating to health and social care, which include: 

  • The Medicines and Medical Devices Bill (p35), which aims to ensure that the UK remains at the forefront of the global life sciences industry after Brexit, by finding cures for rare diseases, advancing current treatments and speeding up access to innovative medicines. 

The Bill aims to make it easier for industry to manufacture and trial the most innovative medicines and diagnostic devices by “removing unnecessary bureaucracy for the lowest risk clinical trials”. Also included are plans to: 

  • Enable the government to increase the range of professions able to prescribe low-risk medicines to make the most effective use of the NHS workforce, as well as developing more innovative ways of dispensing medicines. 
  • Implement a scheme to combat counterfeit medicines entering supply chains and a registration scheme for online sellers in order to ensure patient safety. 
  • Focus upon developments to personalised medicine and artificial intelligence. 
  • Enable the Medicines and Healthcare products Regulatory Agency and the Veterinary Medicines Directorate to develop regulation to enable early access to cutting edge technologies and break new ground in complex clinical trials. 

Keep an eye on how this develops, could your customer base be set to evolve if the range of professionals able to prescribe low-risk medicines changes? Or do online sellers represent a new customer base? Could access to the latest innovation come sooner than you think?  

  • The Health Service Safety Investigations Bill sets out plans to establish a new independent healthcare safety investigation body that will have legal powers to investigate serious healthcare incidents in order to improve patient safety. This will be an extremely important body for people working in quality and assurance roles and could represent joint working opportunities. 
  • The Long-term Plan Bill aims to replace parts of the Health and Social Care Act which are no longer fit for purpose, this includes moving away from competition by scrapping section 75 of the 2012 Act, abolishing Monitor and its specific focus on enforcing competition law, as well as abolishing the Trust Development Authority and Competition and Markets Authority. The Bill also aims to make it easier for trusts to merge, provide flexible payment options that move away from the tariff, simplify procurement and allow NHS England and NHS Improvement to merge fully. Although every effort is being made not to have another reorganisation of the NHS, the Bill could have major implications – are you ready for the changes? 

The Queen’s Speech also placed emphasis on reform of the Mental Health Act in order to improve access to treatment and acknowledged the need for reform of the adult social care sector, although this was not tied to any specific legislation.


CQC advocates for investment in technology to improve outcomes
Adult social care and mental health were both key themes in the Care Quality Commission’s (CQC) annual assessment of health and social care which was published this week.

The State of Health Care and Adult Social Care in England 2018/19 presented a worrying picture, with services providing “substandard care because they are understaffed and cannot cope with an ongoing surge in patients”.

In particular, the CQC said performance in hospital emergency departments has continued to get worse, with 44% requiring improvement and another 8% being rated inadequate. Since October 2018, 14 independent mental health hospitals have also been rated as inadequate.

Access to care is a problem across the system, with people not getting the care they need until things have reached crisis point. The CQC reported a 14% fall in the number of mental health beds between 2014/15 and 2018/19, July 2019 also saw the highest proportion of emergency patients spending more than four hours in A&E than any previous July for the last five years.

Increased demand on services has prompted the development of new roles and placed emphasis upon upskilling existing staff, which may present joint working opportunities for industry.

The report also advocates for the use of technology to improve health and care outcomes. However, it said that there are several “barriers” preventing its adoption which include cost, knowledge and attitudes of staff towards technology.

The CQC also said there is also not enough “joined-up thinking between commissioners and providers and advised for the healthcare system to “consider technology in the broader strategic sense, as an enabler of high-quality care”.



Clinicians are blocking access to treatments, experts report
Experts speaking at the Westminster Health Forum session on diabetes and technology on 15 October voiced concerns, stating that diabetes teams in some NHS trusts are blocking patients’ access to new technologies that could improve their care.

The key opinion leaders stated that the poorer access often stemmed from a lack of understanding among individual consultants and departments and a reluctance to offer new devices to patients. 

This should signal alarm bells for industry representatives even if diabetes is not your clinical area. How can you help to improve education and understanding?


In other news…

Three companies have been awarded tenders worth £25m for the express freight service to deliver medicines and medical products within 24 to 48 hours if there's a no-deal Brexit. The dedicated delivery service will get urgent supplies and short shelf-life medicines, like radioisotopes for cancer treatments, rapidly into the country, including by plane where necessary. 

Primary Care Minister Jo Churchill has announced plans to roll out the electronic prescription service nationally in November, with the aim of achieving £300m in efficiencies by 2021. 

The Health Secretary approved £184m of capital loan funding to be shared with 13 trusts in England and to upgrade critical infrastructure and provide the right equipment for staff to carry out their work and provide better patient outcomes. Take a look at the trusts and where spend has been allocated as it may represent opportunities. 

Resources to help local commissioners achieve value for money by estimating the return on investment and cost-effectiveness of public health programmes have been published. They include tools to assess which interventions provide the best value for money, by calculating their costs, benefits and ROI, as well as comparing costs, savings and clinical outcomes, which may provide extremely useful for industry.

Local Authority Health Profiles for 2019 have also been released which provide a snapshot of health and wellbeing for the population of each local authority in England and will enable you to target your products to areas of need.



25 September - 9 October

Quest to invest in health infrastructure represents opportunities for the NHS
Speaking at the NHS Providers Annual Conference in Manchester, the Secretary of State for Health and Social Care Matt Hancock delivered a (somewhat) enlightening speech that covered the key news stories that have been dominating the press.

These include the Long-Term Plan (LTP) Bill, the recently published Health infrastructure plan (HIP) and a call for greater investment in digital technology. The developments have big implications for the NHS and represent a massive opportunity for industry – now is the time to take action.

Changes imminent for the NHS with the LTP Bill
Following a consultation, organisations within the NHS have published their recommendations for the government and parliament on the LTP Bill.

The Bill is focused around achieving greater integration, joint working and collaboration within the NHS as the main drivers for service improvement.

Speaking at the NHS Providers Conference, Hancock said that providers will be empowered “to work collaboratively with other providers and commissioners”, in order to “reduce bureaucracy and procurement costs, improve care and get the best possible return for taxpayers”.

Some of the main recommendations include:

  • Trust mergers
    Trusts should be able to make their own merger decisions in the best interests of patients and so NHS Improvement’s proposed power to direct mergers between foundation trusts has been (FTs) rejected.

It was also advised that providers should be allowed to form joint decision-making committees on a voluntary basis, rather than the alternative of creating integrated care systems (ICS) as new statutory bodies, which would necessitate a major NHS reorganisation.

Industry can expect the number of providers to reduce, with procurement taking place at scale across local areas. This means industry needs to tailor their strategies to reflect the specific needs of local areas.

  • Competition and Markets Authority, Monitor and Trust Development Authority
    The Competition and Markets Authority’s (CMA) role in the NHS, as provided for by the Health and Social Care Act 2012 Act, should be repealed.

Hancock said: “The CMA merger review process adds an unnecessary layer of bureaucracy that’s time consuming and costly with knock-on effects for staff and patients. The proposals recognise that while the CMA has an important public interest role to play, when it comes to things like pharmaceutical pricing, proposed trust mergers are better assessed by the NHS. They’re better placed because quality of care, and best use of NHS resources, should be the guiding principles when it comes to deciding on mergers, tariff-setting and licence conditions.”

The report also advocates that Monitor and the Trust Development Authority should be abolished, along with Monitor’s specific focus and functions in relation to enforcing competition law.

  • Tariffs
    Tariff arrangements are also subject to change, with plans to move away from activity-based payments to population-based payments.

The report also advocates that the Bill should also contain the specific flexibilities on the tariff including the ability to set a “blended tariff” using a national formula, rather than only being able to set a fixed national price.

It is hoped that fair, transparent, locally set prices will make it easier to redesign care across providers, support preventative care models and reduce transaction costs.

  • Procurement
    Procurement is also up for review, with the general consensus being that current arrangements are too complex and result in additional costs that add little value to patients. Hancock said: “We need simpler, more refined procurement, that reduces bureaucracy when you’re developing competitive tender bids, that makes it easier for you to work with commissioners to develop innovative clinical models.”
  • Commissioning
    The report advocates for section 75 of the 2012 Act to be scrapped and for removing the commissioning of NHS healthcare services from the jurisdiction of the Public Contracts Regulations 2015. These changes would remove the presumption of automatic tendering of NHS healthcare services over £615k. The Guardian reports that this will lead to the privatisation of NHS care to be significantly curbed as the requirement had contributed to a big increase in outsourcing of services.
  • NHS England and NHS Improvement
    NHS England and NHS Improvement should be permitted to merge fully, although they should not have any new and additional powers of intervention.

The report also calls for proposed power for NHS Improvement to set annual capital spending limits for NHS FTs to be a narrow “reserve power”, with a requirement to explain why use of the power was necessary; describe what steps it had taken to avoid its use; and also include the response of the FT.

  • Local authorities and health and wellbeing boards
    Closer collaboration with and from local government is needed, with health and wellbeing boards continuing to have an important role in assessing local needs and developing joint health and wellbeing strategies. 

Niall Dickson, chief executive of the NHS Confederation, said: “We are pleased to see that the earlier proposals to enable NHS England and Improvement to direct mergers between NHS foundation trusts have been abandoned. However, we remain concerned about new central powers to impose capital spending limits on providers and this needs to be considered further.”





How could spending limits impact industry?

HIP capital programme aspires to “make NHS infrastructure fit for the future”

Described by Hancock as “the biggest, boldest hospital building programme in a generation”, the HIP, is a concise 23-page document that trails a new government strategy for investing in NHS land, buildings, equipment and technology.

The plan, published by the Department of Health and Social Care (DHSC), sets out a five-year programme of investment in health infrastructure, including a new hospital building programme.

However, “HIP isn’t just about building new hospitals,” Hancock said, “it’s about capital to modernise diagnostics and tech, modernise our primary care and mental health buildings, and help address critical safety issues in the NHS.”

The new regime will provide indicative, five planning envelopes that will be confirmed annually and include capital to:

  • Build new hospitals.
  • Modernise the primary care estate.
  • Improve mental health facilities.
  • Invest in new diagnostics and technology.
  • Help eradicate critical safety issues in the NHS estate.

The report lists six hospitals getting £2.7bn in funding automatically to develop new hospitals, which include:

  • Barts Health Trust
  • Epsom and St Helier Trust
  • West Hertfordshire Trust
  • Princess Alexandra Hospital Trust
  • University Hospitals of Leicester Trust
  • Leeds Teaching Hospitals Trust

With an additional list of 21 trusts receiving seed funding of £100m. Take a look at the sites and see if they are located within your territory.

It is hoped that providing multi-year capital settlements will provide greater certainty to develop capacity, plan effectively, get better value for money and unlock delivery of commitments already made – this could provide opportunities for industry.

Speaking at the NHS Providers Conference, Hancock said that organisations in the NHS need to work together more closely to manage NHS capital expenditure, through greater budget transparency and improved forecasting.

“After all, if one trust breaches capital spending limits, then clearly that’s going to have a knock-on effect on others and their capital plans: we all share the same national pot,” he said.

Integrated care systems (ICS) are due to have primary responsibility for spending within their capital envelopes (covering acute trusts, mental health trusts, community trusts, primary care – and of course linking in with ambulance and specialist trusts) and according to Hancock, there will be a “capital committee” including NHS England, NHS Improvement and DHSC signing off capital nationally.

The DHSC said the investment announced in HIP is on top of the extra £33.9bn a year by 2023 to 2024 that the government is providing to the NHS. It follows the government’s recent commitment of £1.8bn in capital funding for 20 hospital upgrades and other critical infrastructure works for the NHS, as well as the announcement of £200m to replace more than 300 diagnostic machines across the country to help drive earlier cancer diagnosis and improve survival.

The strategy will be welcome news to industry, however, as highlighted by the King’s Fund, the document leaves a “puzzling overall impression for four reasons: its timing (the report was published just a few days after local health and care systems submitted their draft five-year strategic plans for transforming how health and care services are delivered), how the sites were selected, concerns over delivery and its scope”.





Making digital technology a priority
Hancock also reiterated his “passion” for technology at the NHS providers conference, citing the setup of NHSX to drive digitisation and architecture as examples.

Hancock said he wants the NHS to be able to “buy whatever you want, from whoever you want, as long as it’s safe, inter-operable and does the job.” Although he said he had plans to “mandate tech standards for providers.”

He emphasised: “It’s not about getting the latest gadgets and gizmos into the NHS, it’s about ensuring we upgrade slow, outdated – and often dangerous – systems so we can save lives and save time for staff.”


In other news…

Report outlines pressure facing providers 
NHS Providers has published a report that sets out in detail the growing pressures and difficulties trusts face, despite welcome funding pledges from government and a new long term plan for the NHS.

The report calls for:

  • A proper, full, multi-year capital settlement and appropriate sustainable funding for social care and public health.
  • Greater realism about the scale of the challenges facing trusts and the wider health and care sector and the current level of operational instability, which it says places significant constraints on how quickly the new NHS long term plan can be delivered.
  • A funded, credible final NHS workforce plan.
  • Greater clarity on the quality standards the public should expect.

UK invests in research on evolving global health threats
The UK's chief medical officer Professor Dame Sally Davies has announced funding for projects to help combat antimicrobial resistance (AMR) and achieve global universal health coverage. The funding includes: £6.2m to strengthen existing surveillance systems tracking AMR trends across Africa and Asia; and £12m to improve collaborations on health systems research between low- and middle-income countries and the UK.


Have a question related to any of the topics covered here? Ask MIA

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