Daily Insight: Crumbling patience

It has been a costly wait for a new hospital in Manchester.

This is what chief executive Sir Mike Deegan told Steve Barclay in a letter earlier this month. The cost of the “lack of progress” was running at £13m a month, he said.

The rebuild of North Manchester General Hospital is one of the 40 “new hospitals” promised by the government before the end of the decade.

The project has been hit with delays – including for the Manchester hospital, which was once a frontrunner for completion.

And while it waits, costs are going up. Inflation plays a part, but so does the cost of managing a deteriorating Victorian estate.

One example – as Sir Mike explains in the letter – is a recent collapsed ceiling that will shut down theatres for six weeks. The chief executive raised concerns over how this would impact the trust’s ability to tackle the elective backlog.

The hospital is not the only one in the programme having to shut its theatres due to estates issues. Board papers show Epsom and St Helier – now expecting to finish its new hospital at least two years than previously hoped – is having to do the same.

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The integration of health and social care remains a holy grail for local leaders, but what does it look like in reality?

Wirral in Merseyside thought it had achieved a major step, when in June 2017, the bulk of Wirral Council’s social services department was outsourced to Wirral Community Health Care Foundation Trust, transferring around 240 staff in the process.

The contract had an annual cost of £10m, and the trust also took control of the wider social care budget.

This, according to local leaders, made it one of the few places in the country to have made “significant progress towards truly integrated health and care provision”.

However, six years later, the council has decided to bring the service back in house, saying its priorities were not always reflected in how the services were run.

It also noted how a new inspection regime for adult social care was due to be launched by the Care Quality Commission, and it could be seen as a weakness if there was a lack of cross working with other council departments, and if staff under the contract were not aware of the council’s priorities.

A review of the arrangement last year also concluded: “Whilst services have remained safe and of a good quality the review has not evidenced significant and sustained improvement of service outcomes for people through delivering under the current delegated arrangements.”