Sir David Nicholson, NHS Chief Executive, has admitted taking control of NHS finances whilst the Government’s reforms to the health service take shape.

Speaking at the Local Government Association, Sir David said he had a greater hold of NHS finances than ever before to oversee and control budgets.

He told delegates that despite talk about “localism” he has “more control nationally” and he refused to apologise for that.

Despite taking control of finances nationally, Sir David stressed the importance of “joined-up, integrated services” when the NHS reforms were fully functional.

The Chief Executive admitted that patients in the past had been failed by a “lot of services on the cusp of health and social care” and said there was a “strong case for bringing in innovation from the wider sector” to address previous errors.

He also admitted that the health service had “raided the public health budget” to “bail out” other parts of the system. The admission is likely to affect future public health budgets after the Government said it would base council funding on historical NHS spending.

Independent provider Serco has systematically understaffed its out-of-hours NHS primary care service in Cornwall, according to the Care Quality Commission.

The watchdog found that Serco placed patients at risk by employing too few doctors and failing to train call centre staff adequately.

Serco, which is paid £7.5m per year to provide the out-of-hours service, failed on four out of eight essential standards reviewed by the CQC.

The inspectors found that doctors worked 13-hour night shifts and 11-hour day shifts over the Easter weekend in 2011. Sometimes GP shifts were unfilled or doctors were reassigned from home visits to the call centre.

Following local complaints, the CQC investigated a Truro call centre and five GP clinics in Cornwall. It found that Serco was failing to provide adequate staffing or staff support and to monitor the quality of service provision.

However, the CQC did not find Serco guilty of falsifying performance data (as had been alleged), saying only that the company failed to deal with known flaws in its computer system.

Ian Biggs, CQC Deputy Director for the south of England, said: “At times, Serco has not had enough doctors on duty, and it is hardly surprising that people have complained.

“However, we note that the service has already recruited more GPs and has introduced a new triage system to cope more effectively with calls.”

He added that Serco had not been “deliberately misleading” the public, but that its “system of monitoring performance is unreliable”.

NICE will take over responsibilities for assessing expensive drugs for patients who suffer rare conditions from The Advisory Group for National Specialised Services (AGNSS).

The Institute assume the duties of the Group from 1 April 2013 to create an “impartial and robust mechanism” to providing advice to the NHS Commissioning Board.

Health Minister Lord Howe said NICE will build on the work developed by AGNSS to “ensure that the needs of people with rare and very rare conditions are properly considered.”

AGNSS will formally cease as a body when NICE takes full control of its new role from next year.

Professor Sir Michael Rawlins (pictured), Chairman of NICE, said the drug regulator was looking forward to taking on its new duty. “As with all our work, we will be consulting widely with patients, carers, clinicians, commissioners and industry to ensure that we develop a robust and transparent process for making decisions about these highly specialised drugs.”

NICE will now begin to develop interim methods for the first assessments and will begin a consultation exercise in 2013/14 to ensure their process is “robust, transparent and consistent”.

The NHS Commissioning Board Authority (NHSCBA) has appointed the first 16 local area team (LAT) directors.

Six positions in the North, a further six in Midlands and East, three in the South and one in London have been filled during the first round of recruitment.

Ian Dalton, Chief Operating Officer and Deputy Chief Executive of the NHS Commissioning Board Authority, was “delighted” that “key appointments to such important leadership posts” were filled.

In total, there will be 27 local area teams – but London will have an integrated structure with one director controlling three LATs to reflect the “distinct nature” of the capital. The NHSBA hopes to complete the recruitment process “shortly”.

Appointments include Chris Long, current Chief Executive of NHS North Yorkshire and York PCT Cluster and NHS Humberside PCT Cluster, for North Yorkshire and Humber LAT in the north.

Wendy Saviour, Director of Partnerships at the NHSCBA, will lead Birmingham and Black Country in Midlands and East; Simon Weldon has been appointed to head the London LAT; and Debbie Fleming, SHIP PCT Cluster Chief Executive, will oversee Wessex.

LATs will have the same core functions around CCG development and assurance, emergency planning, resilience and response, quality and safety, configuration, system oversight and partnership and stakeholder engagement.

Senior leaders of LATs will also join health and wellbeing boards as partners.

Teams will also be responsible for commissioning GP services, dental services, pharmacy and certain optical services. Ten LATs will lead specialised commissioning, with a handful also commissioning other services such as military and prison health.

“This puts us in a position to quickly develop the local presence of the NHS Commissioning Board, building strong relationships with our partners and communities to firmly focus on driving improvement for our patients,” said Ian Dalton.

Many NHS hospitals are failing to maintain stable care teams or continuity of care, according to a survey of the Royal College of Physicians.

Breakdown of care regimes at weekends was identified as a threat to patient safety by a quarter of RCP members.

Other concerns raised by the RCP’s Future Hospital Commission include lack of compassion towards patients and poor aftercare following discharge.

The Commission’s interim proposals this autumn may include focusing resources on smaller number of larger hospitals.

Tim Evans, Academic Vice President of the RCP, reported to the college that many hospitals provide “disjointed” care with breakdowns in activity and in transfer of responsibility.

Increased risk to patients at weekends was highlighted as a major concern, with Evans saying it was better to have slightly suboptimal care on all days than to have serious health inequalities built into the weekly schedule.

The survey showed that 24% of RCP members did not think their hospitals delivered continuity of care; 23% did not think stable care teams were maintained; and 17% did not think aftercare following discharge was adequate.

Major underlying concerns raised by members included ‘efficiency savings’ (52%) and clinical staff shortages (49%).

The Commission has identified five ‘workstreams’ as priority areas: compassion towards patients; design of care settings and processes; staffing and teamwork; data handling; and care planning.

The RCP plans to publish its interim proposals in September and its full report in March 2013.