Next steps on NHS response to COVID-19: a missive from NHS England and NHS Improvement

Last night Sir Simon Stevens and Amanda Pritchard wrote to NHS leaders in all hospital trusts, clinical commissioning groups, general practice and Primary Care Networks and providers of community health services, setting out important steps being asked of every part of the NHS to put in place to redirect staff and resources to prepare for the rapidly increasing pandemic.

The letter comes ahead of the emergency bill that will introduce new measures “ protect the nation’s public health and ensure NHS and social care staff are supported to deal with significant extra pressure on the health system.”

It sets out six measures for providers and commissioners to enact now. We highlight a few of the steps being taken:

  • postponing all non-urgent elective operations
  • block-buying capacity in independent hospitals and community health providers and social care providers freeing up care beds
  • providing refresher training for all clinical and patient facing staff
  • removing routine burdens, such as:
    • cancelling all routine CQC inspections immediately;
    • providing staffing and regulatory flexibilities with the introduction of the emergency legislation this week;
    • moving to block contract payments ‘on account’ for NHS trusts and foundation trusts from 1 April to 1 July 2020 with suspension of PBR national tariff payment; and
    • additional funding to cover extra costs of responding to the coronavirus emergency.

Specific financial guidance on how to estimate, report against, and be reimbursed for these additional costs is to be issued this week but for now the Annex to the letter (Coronavirus cost reimbursement) sets out amended financial arrangements for the NHS for the period between 1 April and 31 July and confirms that the changes will enable the NHS and partner organisations (including Local Authorities and the Independent Sector) to respond to COVID-19.

Payments on account will shortly be made to all acute and ambulance providers to cover the costs of COVID-19-related work done so far this year, with final costs for the current financial year being confirmed as part of the year end processes. All NHS providers and commissioners must carefully record the costs incurred in responding to the outbreak and will be required to report actual costs incurred on a monthly basis.

There is a final comment from Sir Stevens indicating that providers and commissioners should use their “...discretion to do the right thing in your particular circumstances” within the national framework.

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