The must-read stories and debate in health policy and leadership.
- Today’s sideways look at the big story: Sajid Javid’s in-tray
- Today’s other big resignation: FT chief stands down after more than a decade in job
NHS England has grand ambitions for changing how the health service buys around £17bn of non-NHS goods and services.
The plan is for procurement to be based at the level of integrated care systems. The ICS footprints will be the new base level for procurement activity, rather than individual providers. The idea is this brings economies of scale and cuts duplication and variation in the procurement process.
In practice, it means local trust teams are combining forces with neighbours, writing a procurement strategy to cover their ICS, appointing an ICS procurement lead, aligning their procurement systems and sharing commercial information.
However, the 42 ICSs in England are at different levels of development. Most have signed on to the idea of ICS-level procurement but only four have got as far as nominating an ICS procurement lead. Systems have told the centre they need more help.
NHSE has therefore put together guidance and support “on how to best structure ICS-based procurement activity”. It is also offering “implementation support” based on how mature a system is. The least advanced will get “extensive” support; it’ll be “light touch” for the most advanced.
A series of suspected governance failings at Royal Cornwall Hospitals Trust have been set out by NHS England/Improvement.
The regulator has published some details of a troubling report into RCHT, which raise a number of questions that need answering.
According to NHSE/I, there are “reasonable grounds to suspect” that RCHT decisions were being made “inappropriately outside of agreed governance processes and structures”, and that those decisions were made “in the interests of individuals, rather than in accordance with trust policy”.
Those decisions also are suspected to have been made by people without the appropriate authority, and there is also a “potential loss of funds” to contend with.
The independent report has not been published, and there is currently nothing in the public domain which explains who the individuals in question are or what action has been taken in regards to the alleged improper decision making and use of public funds.
HSJ last month reported that whistleblowers had raised concerns about RCHT board members being paid thousands of pounds inappropriately, with the trust confirming that “incorrect payments” had been made.
Has the lost funding been recovered? Why the payments made in the first place? Who signed them off? There are many questions.
Finally, what role has the trust’s CEO Kate Shields played in this damaging episode for the trust?
Her new appointment as CEO of the Cornwall and Isles of Scilly Integrated Care System – despite having presided over such serious alleged breaches of governance – raises perhaps the most significant question of all.