Daily Insight: It’s grim up Northumberland

It’s grim up Northumberland

Some moderate embarrassment for NHS England, after it emerged the national body was asking a struggling clinical commissioning group to under-report its financial deficit by £35m.

Northumberland CCG – which is rated “inadequate” and is under legal directions from the regulator – has officially been forecasting a £5m deficit for 2016-17, but board papers this month reveal the financial gap has spiralled to the point where it is expecting to end the year with a £41m deficit.

But, more controversially, the governing body papers published this month also reveal NHS England had asked the CCG to continue reporting its deficit as £5m instead of the full £41m.

A spokesman told HSJ that NHS England had to have a clear understanding of why a CCG’s financial position was deteriorating and what action is being taken before a “budget movement is ‘baked in’ to a valid forecast”.

It seems appropriate for the national body to use a culinary analogy when it has been caught with its fingers in the pie, and could be accused of asking the CCG to cook the books.

The worsening deficit could also put the CCG in breach of its legal direction which require it to ensure an in-year deficit of no more than £5m.

Northumberland CCG is also the main commissioner in the accountable care organisation being spearheaded by Northumbria Healthcare Foundation Trust.

Its deteriorating financial position also raises important questions about whether there is enough money in the local system to set up an ACO which doesn’t fall over the instant it goes live.

STP awaits leadership

At the beginning of the week we reported that Mark Rogers would be stepping down as chief executive of Birmingham City Council. It’s now the end of the week, and there’s still no word on whether he will stop being the Birmingham and Solihull sustainability and transformation plan lead.

He probably will, though. The more serious question is: which highly regarded local NHS provider chief executive will replace him? Happily, Birmingham has an embarrassment of options in that regard.

Contract transfer plan may be scrapped

NHS Improvement is considering scrapping a mooted transfer of community services after care quality concerns were raised about the preferred provider.

Bridgewater Community Healthcare Foundation Trust was nominated to take over from Liverpool Community Health Trust – which is being disbanded after serious care and governance failings were exposed.

NHSI said it was “pausing” the planned takeover after the CQC then raised concerns about Bridgewater.

Now, HSJ has revealed that the regulator, which is reviewing the matter, is considering three options, including one to terminate the transaction.

Andrew Morgan, an NHSI senior delivery and improvement lead for Yorkshire and Humber, will “undertake an options appraisal to establish whether or not a more beneficial transaction or management approach for patients could be realised”.

Bridgewater says its draft CQC report was known and shared during the transaction process – but NHSI has been lobbied by West Lancashire MP Rosie Cooper to restart the process.