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Country matters

It’s been a busy week for the Black Country with one partnership being formed and another put on ice.

After holding out for two years, the Royal Wolverhampton finally joins the Black Country Alliance. Having initially declined join the arrangement formed by Sandwell and West Birmingham Hospitals, the Dudley Group and Walsall Healthcare in 2015, Wolverhampton has decided to join them. The only condition being that the alliance changes its name.

Now called the Black Country Provider Partnership (not to be confused with the mental health trust with a similar name), this new power marriage is set to reign over all acute care in the Black Country.

The partnership comes as all four trusts attempt consolidate their pathology services. The trusts have published a full business case for merging the services and are predicting it will save them £6.7m a year. The target model for the merger is to have a central hub based at Royal Wolverhampton and three smaller labs for urgent diagnostics at the other trusts.

It is curious that this forecast exceeds the £5.1m saving predicted by NHS Improvement in its vision for pathology networks across the country. Although in the regulator’s plan, Shrewsbury and Telford Hospitals Trust is also included in the network.

While one union was formed another has been paused. The highly anticipated merger of Birmingham Community Hospital, the Black Country Partnership; and Dudley and Walsall Healthcare Partnership, has been temporarily iced. This merger was a significant cog in the STP’s plans for mental health and the reasons for its pause are unclear. According to the trusts, time for “additional preparatory work is needed”.

The bottom line

Trust leaders have called for a significant proportion of the £335m winter pressures fund to boost the bottom line of hospitals that have already purchased extra capacity.

Discussions are ongoing around the extra money, announced in last month’s budget, which the government expects to help the NHS improve performance against accident and emergency and elective waiting time standards.

Trusts were told to submit bids for a share of the funding by 1 December and system leaders are expected to finalise allocations by next week. The allocations are being drawn up by the national urgent and emergency care directorate, led by Dame Pauline Philip, who works across NHS Improvement and NHS England.

HSJ understands a majority of the funding, around £200m, could be used to fund extra capacity that some trusts have already been adding in preparation for winter. This would effectively compensate for extra expenditure they have already committed to and which may have resulted in a larger financial deficit.

The remaining money would potentially be spent on new capacity such as social care packages.

System leaders are also mindful the additional funding could result in increased locum rates and the potential for care home providers to push up prices.