HSJ’s round-up of the day’s must read stories and debate

Keeping chairs in the hot seat

Now is one of the most difficult times in NHS history to be a trust chair.

There are all the usual pressures of helming a complicated organisation, but now with the added performance rock and cash hard place.

(He’s on the executive side, but Norfolk and Norwich University Hospitals Foundation Trust’s Mark Davies this week said the trust was “piggy in the middle” between the CQC ordering the trust to improve services and NHS Improvement ordering it to save money.)

NHSI chief executive Jim Mackey has been explicit about trusts having less freedom from the centre than they did in the more cash-rich recent past.

This means they are more likely to find themselves in an impossible position between the cenre and their organisation.

Trust chairs are (slightly) more likely to be in trouble and always had less operational freedom than their equivalents at FTs.

They also got less pay, which Lord Rose’s review into NHS leadership identified as a problem.

One senior figure pointed out that trust chairs have often had stellar careers in their own field and are being asked to take a significant risk with their reputation in exchange for not much remuneration.

Of course public service is an honour, but ministers seem to agree with NHS Improvement, having rubber stamped all 22 applications to increase the pay of NHS trust chairs in the last year.

The Freedom of Information response to HSJ also revealed that NHSI’s provider leadership cCommittee had convened one “termination of appointment panel” for a chair in August.

All go for an ACO?

Northumbria Healthcare Foundation Trust will take control of a single budget for all local services except primary care from next April in a significant step forward for the new care models programme.

The vanguard trust has confirmed that from April 2017 it will hold a single contract for acute, mental health, community services and adult social care services, establishing a “partially integrated” primary and acute care system.

Local leaders have confirmed the new model of care will be run by an “accountable care organisation” board. A Northumbria Healthcare spokeswoman said the ACO would be a “partnership of the key health providers”, hosted by the trust.

In his latest expert briefing, David Williams looks at how close Northumberland is to being the site of the country’s first accountable care organisation.