Speaking at an event on clinical commissioning held by the think tank Reform in London on Wednesday, Mr Lansley said that in order for clinical commissioning groups (CCGs) to succeed, NHS trusts need to ‘put their own houses in order’.
He said NHS trusts and hospitals must become financially sustainable and provide high quality care, to ensure that CCGs ‘have access to a range of viable sustainable high quality provision within the NHS’.
‘CCGs when they take up their responsibilities have to be focused on using their resources to deliver the best possible care for the patients whom they serve, not, as in the past, seeing themselves as having constantly to have to use a significant part of those resources to manage a system that is failing to manage itself successfully,’ Mr Lansley said.
The onus will be on NHS trusts to improve standards and meet financial targets. The government will offer help to NHS trusts which are struggling but only if they can meet four tough tests showing that they are deserving of support, Mr Lansley said.
There will be ‘no more sticking plaster solutions’, he said.
Mr Lansley said that he would not shy away from closing down providers which were underperforming or putting patients at risk.
‘There is an unsustainable providers' regime… I will not flinch from using it if NHS trusts are failing patients or failing financially,’ he said.
Mr Lansley said that he was not afraid to hold mangers to account for financially and quality failings in trusts.
He said he had a ‘warning’ for managers who were failing to perform; ‘You have signed agreement telling us by when you will be clinically and financially stable.
‘If your hospitals are not there by the time you say – you are not getting there at all.’
The health secretary had the power to replace and remove management teams which fail to deliver and Mr Lansley said he would ‘not hesitate’ to use that power.
Speaking at the same event, chairman elect of the National Association of Primary Care and Surrey GP Dr Charles Alessi said that trusts must have financial responsibility in order for integrated care, a key aspect of clinical commissioning, to work.
‘So for integrated care, we really need to be thinking in terms of secondary care…and they also have a fiscal responsibility,’ Dr Alessi said.
Dr Alessi said that in order to have productive discussions about budgets at health and wellbeing board level, trusts and CCGs must accept the need to share resources.
‘If we accept that we live within a process whereby we have so much resources, and we have to share that equally the discussions… at health and wellbeing board level will be around how we divide and prioritise those resources only,’ Dr Alessi said.