HSJ’s round up of the must read stories and talking points from Friday

The fab four

HSJ has revealed the sustainability and transformation plan areas spearheading a back office savings drive, which we have also learned system leaders estimate can save £350m over four years.

Greater Manchester, Kent and Medway, mid and south Essex, and north west London have been selected by NHS Improvement to be “pathfinders” for the programme after being impressed by their October STP submissions.

Our back of a napkin calculation, which seems appropriate in the post-truth age, suggests this means the 44 STPs will have to find around £8m of savings each over four years.

Cue wailing and gnashing of teeth from the unions – which rightly have concerns about their members’ jobs – and those fearing a re-run of the commissioning support unit debacle and haunted by other botched implementations of a similar ilk.

Big organisational consolidations are always messy, fraught with unintended consequences and painful for staff. But there is evidence from local government, which has already grasped this nettle, that when there is sufficient buy-in and hard graft from the different parties involved, they can work.

The tri-borough shared service between three London councils and the LGSS, a shared service jointly owned by Cambridgeshire, Northamptonshire and Milton Keynes councils, are both held up as relatively successful ventures.

However, savings for the NHS will be demanded on a breakneck timetable and the projects will be bigger than the council tie-ups, so a challenging journey lies ahead for those involved. Staff engagement will be crucial to ensure morale, already at rock bottom, is protected as much as possible.

PACS in prime position

Plans for an accountable care organisation in the North East have taken a major step forward. HSJ revealed on Friday the plan to make the chief executive of Northumberland County Council accountable officer of the region’s CCG.

HSJ has learned that Steven Mason will take over the accountable officer role at Northumberland CCG from Alistair Blair, who is expected to become independent chair of the ACO board.

The move, which is yet to be officially announced but was due to take effect from 1 December, paves the way for the region’s ACO by allowing the council and CCG to jointly commission health and social care.

No mergers are on the cards and because the two organisations will remain distinct bodies, the move allows them to legally fulfil their statutory commissioning duties.

Leaders are still aiming to have a “partially integrated” PACS up and running by April, but with the outline and full business cases still needing to be produced and the new contract yet to be drawn up and signed by all parties this could be pushed back.

Northumbria is as likely as anywhere else to become the first primary and acute care system running on a new contract if it goes live as planned, though full integration is still some way off as GPs will be contracted separately for the time being. A recent prior information notice showed that Northumbria Healthcare Foundation Trust will hold a single contract for acute, mental health, community services and adult social care – but not primary care.

There are also questions about how the region’s GPs will be represented on the joint ACO board. The project is moving forward at pace but with a number of hurdles to overcome.