, 8 tweets, 2 min read Read on Twitter
BBC reports extra £1bn for NHS capital spending this yr. There’s a catch: The £1bn is cash hospitals and other NHS trusts already have but have been forbidden to spend. They earned it last yr in incentive payments for cutting their costs [thread, 1/8ish]
The “PSF” incentive deal was this: cut your costs and report a surplus in your accounts, and the government will give you a big fat cash reward in return that you can spend on new kit and building repairs [2/8]
The incentive scheme has been running for 3 yrs and has typically seen between 70 and 90 NHS trusts in England cut their spending each yr by 50% more than they need to breakeven, in return for a total £2.3bn in cash rewards. More about it here nuffieldtrust.org.uk/news-item/havi… [3/8]
It was important to the government that PSF cash was not spent on everyday costs like staff and medicines, because spending it like that would increase the reported overspend in the NHS’s operating costs [4/8]
So the deal was it could be spent on capital - reported separately in the accounts. But NHS trust capital spending has to sit within the Dept of Health & Social Care’s capital spending limit, even when trusts are spending their own cash. [5/8]
Cuts to that spending limit have meant trusts have been told they can’t spend the £2.3bn cash surplus they earned under the PSF scheme over the last 3 yrs after all, making the cuts they made to everyday spending even sorer [6/8]
Earlier this yr the government even considered changing the law to effectively make it illegal for a hospital to SPEND ITS OWN CASH on new equipment and building without the dept signing it off [7/8]
News that £1bn will now be available this year is a welcome reprieve, but it’s the equivalent of giving someone cash then banning them from spending it, only to expect cheers of jubilation when you later decide they can spend it after all [8/8]
Missing some Tweet in this thread?
You can try to force a refresh.

Like this thread? Get email updates or save it to PDF!

Subscribe to Sally Gainsbury
Profile picture

Get real-time email alerts when new unrolls are available from this author!

This content may be removed anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!