NHS England has warned local commissioners that offer providers extra income in order to deliver financial targets that they could be personally scrutinised by national officials.
In announcing this intention, NHS England hopes to ensure that the NHS system operates more prudently.
And reports have indicated that discretionary payments have already been discussed between trusts and clinical commissioning groups, with the hope of ensuring sustainability and transformation funding is delivered.
Extra income paid to trusts for 2016/17 could then be returned to the CCG in 2017/18.
With this in mind, some clinical commissioning groups are already considering whether securing funding for the health economy should take priority over meeting existing financial targets.
In recent years, health care trusts and CCGs have done a poor job in meeting such fiscal goals.
A spokesman for NHS England outlined the position of the authorities on the matter.
“Individual CCGs need to honour their agreed year-end financial delivery commitments, which are critical to securing the overall NHS financial position. Therefore any substantial last minute adverse movement by a CCG – whether or not related to the STF – will be subject to external review by auditors appointed by NHS England plus national scrutiny involving the CCG’s audit committee chair, finance director and accountable officer personally.”
Jim Mackey, chief executive of NHS Improvement, had previously told the Health Service Journal that such an approach was appropriate.
“If it’s meant commissioners and providers sit out and say how do we work together to get some bonus in the system that we can’t spend now or next year, but we might be able to spend at some point in the future, fantastic. As long as it’s not one part doing something at the expense of the other; so there’s a process as to how does this work, how does it unwind [and] it’s not going to pop up as a problem on the commissioner side.”
One major concern is that extra payments to providers could impact negatively on the fiscal position of the commissioning sector.
This is particularly worrying, as the balance of payments for these organisations are already fragile.
And a letter to clinical commissioning groups from NHS in England from financial officer Paul Baumann already expressly stated that it is particularly critical to avoid last minute adverse movements.
“Any such late changes may trigger an urgent external review, and any late changes would be “repayable in full as an adjustment to existing 2017-18 control totals,” Baumann noted.