The must-read stories and debate in health policy and leadership

A fly on the wall

Tales of Jeremy Hunt’s Monday meetings have gained a level of infamy among NHS leaders, and after some negotiation HSJ was given unprecedented access to observe the meetings and write a ‘fly on the wall reportage’ of the discussions.

Conscious of the observer effect, this was not designed to reveal what the Monday meetings are always like, but what we were able to discern from conversations with civil servants and senior NHS figures is that the meetings are now largely welcomed as a mechanism to have a joined up view of what is going on.

Mr Hunt challenged civil servants when he felt their proposals were lacking in ambition and he clearly showed a tendency to make a sudden decision and move on. But elsewhere he invited challenge and asked to be told his view was “complete nonsense”.

What our observations revealed was what many taxpayers might be forgiven for thinking was always the case; that a minister with legislative responsibility to parliament is keen to fulfil his duty to oversee the operation of the health service.

The fact the meetings have gained so much notoriety and interest says more perhaps about the state of affairs before they were established.

Working on the chain

Glen Burley is growing a small empire in the West Midlands, with the announcement that he’ll soon become chief executive of a third trust.

Mr Burley will be taking over from Kath Kelly at George Eliot Hospital Trust, who announced her retirement yesterday.

As chief executive of George Eliot Hospital, Wye Valley Trust and South Warwickshire FT, Mr Burely will preside over a chain of small combined acute and community trusts stretching across Herefordshire and Warwickshire.

This foundation group model, which George Eliot will now join, has been under development at Wye Valley Trust and South Warwickshire FT for several years.

The focus, unlike some of its larger hospital chain counterparts, appears to be on leadership, strategy and shared practice (with a pinch of back office consolidation), rather than rationalising clinical services or as a step towards a full merger.

SWFT is among the best performing small hospital trusts in the country, while Wye Valley and George Eliot are both struggling.

Despite its reach, the scale of the group is still small.

Even together the three trusts have a combined income of just £580m, which is less than the nearest major tertiary trust (University Hospitals Coventry and Warwickshire at about £609m).

But for George Eliot, which has flirted with takeovers for years, joining the group has the attraction of additional support for its long-standing challenges while still retaining some local control (the trust will retain a separate board, for instance).

If the model proves itself, it could be attractive for other small district hospital trusts caught between isolation and being swallowed by a larger neighbour.