Essential insight into England’s biggest health economy, by Ben Clover

Joint ventures

In the NHS, “joint ventures” is a term usually associated with pathology partnerships. These are at different stages across the capital, from University College London Hospitals and the Royal Free’s HSL partnership, to Viapath in south London.

But I increasingly hear the term in relation to primary care, specifically primary care working with provider trusts.

The idea of large trusts having anything to do with the running of primary care in London is sensitive, and the more thoughtful trust leaders are sympathetic to the reasons general practitioners have for not wanting to get involved with them.

But could the seemingly inexorable pressure on the traditional partnership model lead to a sea change in London?

I’ve heard of examples where joint ventures are under discussion, although still very nascent.

The argument for any of this, apart from the sustainability of primary care, is to integrate services better – and Croydon has been doing interesting work on this front for a while.

Croydon Health Services Trust chief executive John Goulston will retire in September but the work he has contributed to the integration of care for over-65s in the borough will hopefully survive his departure.

Late last month the One Croydon alliance – which includes the trust, South London and Maudsley Foundation Trust, the clinical commissioning group, GP collaborative, the council and Age UK Croydon – signed a nine year extension to the existing contract for older people’s services. 

The project says its pooled budget and joint working has so far seen 62 per cent fewer patients with chronic conditions needing care packages six weeks after discharge.

The contract extension commits the partners to expanding the range of people it plans care and treatment for. This, and the gradual increase in Croydon’s historically undercapitated budget, will hopefully address some of the long standing access and performance issues in the borough.

Governance at London’s Shelford Group trusts

I understand Imperial has not been deluged with applicants for the chief executive role.

Regular readers will remember that Ian Dalton succeeded Tracey Batten in July for just four months before taking up the top job at NHS Improvement. 

The organisation has had some interesting governance arrangements in the recent past, with chair Sir Richard Sykes briefly sharing the chief executive role with the then medical director and finance director. Sir Richard’s tenure has been extended to the end of this calendar year but after that it will be interesting to see what direction a new leadership team might want to go in, in the era of hospital chains and integrated care systems.

South of the river, King’s College Hospital FT is also lacking a chief executive, though its chair has only just begun his tenure.

Across the Shelford Group, the profile of chief executives has changed. When it was set up, most of the leaders of its 10 trusts were knights or dames and had come from a management background.

But with the recent or pending retirements of Sir Andrew Cash at Sheffield, Sir Robert Naylor at UCLH, Dame Julie Moore at University Hospitals Birmingham and the sacking of Newcastle’s Sir Len Fenwick, the group is in quite different hands now. Clinical academic leaders from overseas are in place at UCLH and Oxford, while the future leadership of King’s, Imperial, Sheffield and UHB remains to be seen.

Staying with the Shelford Group, HSJ has faced some criticism for not writing a news piece about the case of King’s interim chief finance officer Alan Goldsman.

Mr Goldsman is listed on the website of the Institute of Chartered Accountants for England and Wales as having signed a legal undertaking not to represent himself as a member.

The trust told HSJ Mr Goldsman qualified as an accountant in New Zealand and that he had signed the undertaking because third party websites had erroneously listed him as having the ICAEW’s qualification (the ACA).

The ICAEW did not confirm whether it believed these listings were accidental, and did not share any of its evidence. In this light, we felt it was not fair to write a news piece about what could have been an innocent mistake by third parties, though Private Eye has done.

Mr Goldsman was finance director at the Royal Marsden FT for more than a decade and had also been interim finance director at Imperial.