HSJ’s round-up of Friday’s must read stories

High powered gang of four

NHS Improvement has given four high performing acute trusts the power to lead groups or chains of hospitals, effectively giving them the green light to begin setting up partnerships, federations or even mergers and acquisitions.

All four foundation trusts are part of acute care collaborations and the national accreditation as “foundation group leaders” gives them the power to begin implementing their vanguard plans.

In the quartet, Northumbria Healthcare and Salford Royal have both been rated outstanding by the CQC, while Guy’s and St Thomas’ and the Royal Free London are rated good.

Each has been approved by NHSI to consolidate hospital services, with options including buddying, partnerships, federations of hospitals and M&A.

Plans are still being hammered out, but include sharing clinical standards, back office corporate services and the creation of a standard operating model, which each trust joining a group will have to adopt.

NHSI chief Jim Mackey hailed the development as a “big step forward” which would allow patients and providers to benefit from the best leadership in the health service.

Mr Mackey, who until last year was chief executive of Northumbria Healthcare, also said being in a group was “not right for everyone”.

But questions remain over the specifics of the plans and what new powers the foundation group leaders will actually have. Does the announcement mean NHSI will give them more more powers to implement their plans, or is it just a reassurance from the centre that regulators will support their plans through thick and thin?

How will being a leader of a group impact on the chain’s relationship with neighbouring trusts, and what changes will the CQC make in order to inspect them?

A quality conundrum

The Care Quality Commission has set up a review to try to discover the “underlying reasons” why providers are failing to improve between their first inspection and re-inspection.

It comes after 17 of the 23 re-inspections by the CQC in 2015-16 failed to show overall improvement at the trusts in question.

In total, 21 trusts were re-inspected – with Hinchingbroke Health Care Trust and Colchester Hospital University Foundation Trust visited twice in the year – and of these only six had improved. Only two, Alder Hey Children’s FT and Peterborough and Stamford Hospitals FT, were found to have improved enough to be rated good. The other four had all moved from inadequate to requires improvement, though as of this month Hinchingbrooke is also rated good.

Worryingly, Colchester and Sherwood Forest Hospitals foundation trusts were found to have got worse during the last inspection year and are both now rated inadequate.

Four more trusts, despite being set improvement actions by the CQC, remained inadequate after their second inspection. Nine remained stuck on requires improvement.