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Arbitration results revealed

NHS England has released details of three arbitration cases between commissioners and trusts in disagreement over millions of pounds.

The documents, obtained by HSJ, show:

  • Brighton and Sussex University Hospitals Trust won a £6m dispute with NHS England over savings the national commissioning body was demanding on a specialist contract.
  • Mid Yorkshire Hospitals Trust won £8m from two clinical commissioning groups over transitional support and legacy costs.
  • Sandwell and West Birmingham CCG won its dispute with a local provider over contributing to rebuilding a hospital and invoicing for community services.

In July, HSJ reported the outcome of the £6m dispute between BSUH and NHS England, which NHS England had tried to keep secret.

An internal NHS England email obtained by HSJ showed a senior communications consultant writing to NHS England to say revealing details of the trust’s successful challenge might encourage other providers to do the same.

Big spenders

Commissioners in north west London spent £36m on consultancy firms over the last four financial years – including millions on service redesign recently stalled by NHS Improvement.

North west London, which has been working on a major reconfiguration of services since 2011, spent more than £16m with McKinsey and McKinsey led projects in the four years up to the end of 2016-17, clinical commissioning group data reveals.

The consultancy spending data shows in 2014-15, commissioners spent £301,000 with M&C Saatchi Group on work related to the closure of the Hammersmith and Central Middlesex A&E units.

Of the money spent with McKinsey, £9m was on the whole system integrated care programme.

Command and control is back

Leaders of CCGs and senior officials in NHS England have complained of “confusing accountability” and a return to “command and control” management, according to a new report by the Nuffield Trust.

The report, shared exclusively with HSJ, said these problems could hamper work to join up services through sustainability and transformation partnerships and accountable care systems.

It is based on accounts from senior CCG leaders, interviews with senior NHS England staff, including in its regional and local teams, and analysis of the current system.

One NHS England official said anxiety in the NHS and government about NHS delivery had led to an “absolutely ridiculous” amount of information being collected centrally.

Another official said while they used to “coach” CCGs they are now “requiring them to make changes”. Nearly all CCG interviewees said there was little support available to them, the report said.

One CCG leader said: “It seems that the natural behaviour at senior echelons of the NHS is to think it’s motivating to threaten you with your job. It doesn’t motivate me.”