Every ICS expected to break even in ‘harsh’ new regime

Every health and care system — including those carrying huge deficits going into the pandemic — will be told to deliver financial balance in 2022-23, according to draft guidance seen by HSJ.

For the last two years, local NHS organisations have effectively seen all their spending covered by the government under temporary Covid measures.

But a more typical financial regime is now due to begin in April, with systems expected to deliver services from within funding envelopes set at the start of the year, and to be held to account on this.

Some integrated care systems went into the pandemic with deficits of more than £100m, and will likely struggle to reach a balanced position.

But draft guidance circulated to local leaders in recent months by NHS England says: “NHS England and NHS Improvement intend to use additional powers in the legislation to set a financial objective for each integrated care board [the local commissioning body] and its partner trusts to deliver a financially balanced system, namely a duty on break even.”

However, it is unclear what the consequences will be for an ICS that fails to meet what is described as a “new joint legal duty”.

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Source: HSJ, 31 March 2022