Skip to main content

ICB chair resigns after refusing ‘to sign off another cut’

Published on: 11 Jun 2024

An integrated care board chair has resigned saying she “did not feel able to sign off on a further cut”, and warning its budget plans required “unacceptable consequences”.

Devon Integrated Care Board chair Sarah Wollaston announced her resignation this morning on “X”, formally Twitter.

She said it was made “with regret”, but was also critical of recent changes to the NHS England financial regime.

Dr Wollaston is a former GP who became a Conservative MP in 2010 but left the party in 2019 in a dispute over Brexit, later joined the Liberal Democrats, and lost her seat later in 2019.

She became ICB chair in 2022.

Dr Wollaston said: “Thank you to all the wonderful NHS, care and voluntary sector teams that are out there doing their very best in challenging circumstances. Did not feel able to sign off on a further cut; elastic already stretched too far.”

She added: “Genuinely sad to be leaving NHS Devon but in a nutshell, not happy as chair to sign off on the financials so time for me to go. No point promising the unachievable, especially if only achievable with unacceptable consequences.”

Her move comes halfway through the general election campaign and with additional capital funding a key ask of the NHS.

Referring to recent changes to the lack of national capital funding, and recent capital rules which reward systems performing better on other measures, Dr Wollaston, who also chaired the Commons health and social care committee for several years, went on: “It really makes no sense to ‘punish’ the most challenged systems with penalties on their capital budgets when access to capital is essential to improving their performance, conditions and safety.

“The state of our infrastructure in too many places is frankly shocking… The next government needs to stop the cycle of capital-to-revenue transfers and pay serious attention to investing in NHS infrastructure. Also need to address the shocking waste of public money and lost opportunities due to delays in accessing capital.”

Devon ICB is one of the NHS’ most challenged systems, with significant financial and performance problems, and is subject to the highest level of scrutiny under NHSE’s performance regime. Many systems are forecasting deficits for 2024-25, and have been asked to revise their plans by NHSE.

Meanwhile, recent changes to the NHS financial regime state that integrated care systems in deficit will have their capital allocation reduced by up to 10 per cent. Trusts doing better on accident and emergency performance are also now being rewarded with additional capital funding. 

Earlier this year, HSJ revealed capital budgets had been raided by almost £1bn, including £200m in the new hospital programme, to fund day-to-day cost pressures, including unfunded pay rises and industrial action costs.

North Devon District Hospital in Barnstaple, which is the most remote district general hospital in England, was included in the government’s “40 new hospitals” pledge in 2019 for redevelopment between 2025 and 2030.

However, last May, ministers delayed eight projects – including NDDH – until 2031 at the earliest, in order to prioritise other hospitals with extensive RAAC. No reason was given for the trust’s project being postponed.

Its leaders have warned of the significant risks to patients caused by the delay by the ageing infrastructure, some of which are more than 50 years old.