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The art of expectation management
Of all the frustrations NHS leaders have to deal with, the process for accessing capital funding has to be right up there.
For the last five years, Liverpool Women’s Foundation Trust has been making the case to relocate its services from its standalone site to the new Royal Liverpool Hospital a mile down the road.
The trust had been following a relatively clear process until sustainability and transformation partnerships came along, which meant they had to rewind and build consensus among system partners.
Around £2.5bn has so far been earmarked to local projects through that STP process, but, despite a strong clinical case for relocation and being officially ranked as the top priority for Cheshire and Merseyside, Liverpool Women’s has been overlooked.
Hopes were raised by media coverage trailing the recent capital announcements by the government, but the trust was left to learn of its continued omission through the media, without any form of explanation.
So you can understand the frustration of chief executive Kathryn Thomson, who told HSJ: “I’m really pleased for colleagues up and down the country, but we don’t see any transparency in this process…
“We’ve asked a number of times for feedback on what prevented us getting something, so we could rationalise it, but we’ve never had anything back.
“I think anyone who was potentially in those lists should have been communicated with, so you could manage expectations… I just think it was a disrespectful way of managing what’s such an important issue.”
Rebalancing the scales
NHS England chief executive Simon Stevens has signalled what sounds like a plan to push for the repatriation of some mental health services delivered by the private sector back into the NHS’ arms.
Speaking at a Royal College of Psychiatrists conference, Mr Stevens said growing gaps in NHS mental health provision had been filled by the independent sector, creating an “inappropriate” balance in some areas.
The NHS chief suggested, going forward, the private sector’s chunk of the pie would diminish as NHS services expanded. His comments coincided with NHS England’s announcement it has asked the Children’s Commissioner to set up an independent panel to scrutinise children and adolescent mental health services.
His statements on the private sector’s share - as well as announcing a “taskforce” on inpatient children’s services - may have been pre-empting the Care Quality Commission’s state of care report, due out next week. The report is expected to focus very heavily on mental health inpatient provision, following a string of scandals, including Whorlton Hall, this year.
Many will question quite how - and how quickly - the NHS will go about repatriating services, as a main driver for the private sector’s presence within mental health is the considerable deficit of NHS-owned beds. The NHS would have to get building, and the money for that is not yet there.