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Greater Manchester is under huge pressure from NHS England to reduce its financial deficit, after suffering one of the more dramatic collapses of recent years.

The system had been a strong financial performer over the past decade and submitted a breakeven plan at the start of 2023–24.

However, the plan quickly proved undeliverable and the system ended the year with a £180m deficit.

This has resulted in NHSE triggering a legal process known as “enforcement undertakings”, in which a set of agreed improvements must now be delivered within a set timeframe. It is effectively a form of special measures.

According to minutes from an integrated care system meeting in March, the system submitted an initial financial plan for 2024–25 that suggested a deficit of around £300m, which NHSE deemed “completely unacceptable”. A revised deficit plan of £217m has subsequently been submitted, although this is also likely to be rejected.

And it’s now emerged GM is having to navigate this without its substantive chief finance officer, Sam Simpson, who was seconded to a post within the NHSE regional team last month. It is not clear how long the secondment will last, nor whether Ms Simpson will return to the ICS, but her deputy Kathy Roe has taken over as interim.

In response to questions from HSJ, NHSE said Ms Simpson’s move was not linked to the undertakings or financial difficulties in GM, but was to support regional finance director Nikhil Khashu, who was recently asked to step into a national position while also continuing in his regional post.

Accountability questions stand

Cambridgeshire and Peterborough Foundation Trust’s handling of what was supposed to be a major suicides review has been so chaotic it raises more questions than answers.

The trust announced an internal review of over 60 cases in July 2023, following allegations were made public that a patient’s record was tampered with after they had died by suicide in the trust’s care.

In September, the trust upgraded the probe to an “independently led” review but only after media pressure. It appointed a chair only last month…

So, why then did the trust decide last week to scrap the entire review?

The trust said the decision was taken because after “consulting several families… it became clear it would not answer… highly personal questions some families might have”.

But as HSJ reported yesterday the move has prompted concerns about the “devastating” impact the surprise move could have on some grieving families by a whistleblower, and a family member has also reportedly expressed their “upset and shock”.

The trust is not the only body facing questions. A whistleblower told HSJ: “The Care Quality Commission assured me that this review would get answers…  I’m concerned no one is going to take accountability.”