Another integrated care system has been ordered to bring in consultants to fix its finances, meaning close to a third of the 42 systems are now in mandatory escalation over their finances, writes HSJ.
Norfolk and Waveney joins another 12 ICSs in NHS England’s “investigation and intervention” regime, in which systems have to appoint outside advisers to find rapid ways of making savings.
The ICS has commissioned Deloitte, which was previously looking at trust finances in the system. A spokesman said this would help to ensure value for money by “build[ing] on the work they have already done and the relationships they already have with system partners”.
NHSE’s chief finance officer Julian Kelly previously said there is “no room for any overspends for any system this year”. However, integrated care systems were collectively nearly £500m behind plan as of August.
Meanwhile, Leicester, Leicestershire and Rutland ICS has been placed into tier three of the framework, which is for systems where there is “significant concern” about overspending.
HSJ has also learnt that several systems that are not in the formal programme are appointing firms to carry out similar reviews.
North East and North Cumbria ICS said it was engaging “proactive support”, which will see AuditOne, an NHS audit consortium, and PwC assess spending controls and cost improvement programmes.
Elsewhere, West Yorkshire said it was commissioning PwC to carry out a review to mirror the mandatory specification for other systems following a series of reviews at the system’s acute trusts earlier in the year. The ICB said the latest exercise would build on the previous work and involve all its NHS organisations.
PwC has secured most of the intervention and investigation contracts, alongside PA Consulting, as HSJ has reported previously.
Norfolk and Waveney has estimated it has an underlying financial gap of more than £200m. In the five months to September, it recorded a £38m deficit compared to a plan of £20m, board papers say.
The Queen Elizabeth Hospital King’s Lynn Foundation Trust, which is part of the system, has one of the highest efficiency targets in the country and is cutting a tenth of its beds.
An NHSE spokesperson said: “We are supporting a number of ICBs, including Norfolk and Waveney ICB, to review their finances and take steps to ensure they achieve a position consistent with their board-approved plans for the year.”
Date: 20 November