HSJ’s round-up of the day’s must read health stories and talking points

Homa plays hardball

Nottingham University Hospitals chief executive Peter Homa has told HSJ that the trust will not take on the future PFI costs of Sherwood Forest Hospitals Foundation trust when the organisations merge.

In what will no doubt be watched closely by many trusts carrying the millstone of PFI contracts, it now seems likely that the costs associated with Sherwood Forest’s Kings Mill site will be dealt with centrally.

In a shrewd move, Mr Homa said NUH had made it a requirement of the merger that the PFI costs were not shifted to the trust’s balance book.

Considering the £302m contract, signed in 2005, will last until 2043 and cost a total of £2.5bn, few could argue with Mr Homa’s stance.

What will be interesting is to see how the system proposes to resolve this issue. It seems unlikely the Treasury will want to set a precedent of buying up PFI debt. What is more likely is some form of increased funding to cover the costs of the PFI, which will likely makes it way to the trust via commissioners.

Mr Homa also said he was confident issues affecting Sherwood Forest could be addressed while the merger process was ongoing. He told us: “One of the challenges that Sherwood Forest has, and I am confident we will address, is the complete discontinuity within senior management and leadership. It has had seven chief executives in five years and multiple changes at board and chair level. We will bring some considerable experience and local knowledge to bear as far as that is concerned.

“It is demanding, there is no question about it, but it is doable. There are some issues where the prospect of one organisation is easier to deal with than where there are two. Clearly there will be some economies of scale bringing two organisations together.”

Bumpy road to reconfiguration

Bedfordshire and Milton Keynes clinical commissioning groups face a significant challenge to get their reconfiguration plans rubberstamped as they try to push through a review which begun over two and a half years ago.

As we revealed on Wednesday, the two CCGs’ joint healthcare review has set out proposals which would mean Bedford Hospital Trust would be stripped of major services including obstetrics and the majority of its emergency surgical care.

Bedfordshire CCG clinical chair Alvin Low admitted to HSJ that some Bedford clinicians have “mixed feelings” about obstetrics going to nearby Milton Keynes University Hospital Foundation Trust. “Mixed feelings” may well be a diplomatic way of putting it.

There is still some distance to go for the CCGs to get the plan over the line. It must get past both NHS England and a public consultation. With local politicians already spitting feathers about potential changes, this promises to be challenging.

If it’s any consolation to those making difficult decisions, it’s that many others across the country will have to grasp a similar nettle at some point as commissioners desperately try to forge a sustainable future for NHS services.