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The next challenge for Hinchingbrooke

Hinchingbrooke Health Care Trust’s staff and management deserve huge credit for turning the trust’s performance around and getting out of special measures, but the story about this small but closely watched trust is far from finished.

It was telling that the one area where it still requires improvement, according to the CQC, is its accident and emergency department. As trust chair Alan Burns told HSJ on Thursday, the hospital is struggling to staff the department and demand is “going through the roof”.

The trust is forecasting a significant deficit, and the crucial questions about its future sustainability are very similar to those facing most other small district generals across the NHS.

The management is pinning its hopes of securing clinical and financial sustainability on merging with (or in reality being acquired by) Peterborough and Stamford Hospitals Foundation Trust, which has a whopping deficit, largely related to a private finance initiative deal.

A final business case is expected to be presented to both boards later this year.

Mr Burns was, however, quite clear that his intention is to retain a full service emergency department and not follow the likes of Grantham, a significantly smaller hospital, which announced this week it was considering reducing its emergency department’s opening hours.

He said: “The Cambridgeshire sustainability and transformation plan doesn’t suggest that [reducing A&E hours]. The other clinical reference groups that looked at it in the STP didn’t recommend it. It would be a major, major issue for the population of Huntingdonshire, so we would resist that as much as we possibly could.

“The idea of the merger with [Peterborough and Stamford Hospitals] is about creating sustainable services, not losing them.”

Making the books balance across the two trusts will prove a challenging mission.

Junior doctors contract missive

Earlier this year, junior doctors went on full strike for the first time in 40 years over fears the government’s new contract would not protect them from unsafe working.

Part of this argument was based on the claim NHS trusts could not be trusted without some sort of financial penalty being in place.

Now a letter obtained by HSJ appears to suggest that in the case of a handful of trusts, those fears might have been well founded.

NHS Improvement, along with NHS Employers and Health Education England, has sent a letter to all NHS chief executives warning them about breaching terms of the new contract.

Some trusts have not complied with the rules on appointing guardians for safe working hours, which were supposed to be agreed by consensus with junior doctors.

The letter says in some instances trusts have tried to have more managers on the panels than allowed.

NHSI and NHS Employers have also warned trusts that implementation of the guardian role is to varied and they will intervene if necessary.