HSJ’s round-up of the day’s must read stories

The evolution of devolution

If Greater Manchester’s devolution project was already in force (it goes live on Friday), it could already be subject to “intervention” from NHS England.

A number of performance triggers have been drafted which would allow the national body to take action against poor performance in Greater Manchester.

They include performance on the headline accident and emergency target – NHS England would consider action if fewer than 85 per cent of patients across the region were treated in under four hours. Falling short of the national 95 per cent target would be dealt with by local leaders.

A&E will be a major concern for the devolution team, as several trusts in Greater Manchester are among the worst performers in the country. And nationally, there is severe pressure being applied to providers to improve on this measure.

Collectively, the region’s eight acute trusts only hit the four hour target in 83 per cent of cases in January, meaning performance needs to improve pretty sharpish to avoid the trigger.

If the devolution project is going to crash and burn, then A&E is surely the most likely obstacle.

A blow for councils

“NHS England managed to upset clinicians, researchers and community advocates as it attempted to shunt millions of pounds of cost to councils in one fell swoop,” writes Jim McManus on hsj.co.uk.

The director of public health at Hertfordshire County Council is concerned about the costs of PREP, a treatment as prevention programme for people at high risk of HIV, being passed from NHS England to local councils.

He says that with the specialised commissioning budget under pressure, “passing costs for PREP to councils would be one strand in reducing spiralling costs faced by this budget, in an attempt to avoid busting the Department of Health’s spending budget”.

He asks: “If this can be done with funding for HIV services, will councils be asked to pay for other things, too? Will the NHS financial situation mean councils are expected to take more commissioning burdens?”

Over the next few years several HIV drugs are due to come off patent, with estimates of savings to the NHS being up £1.25bn over five years on recent estimates. “A pot of that size could make a big difference across HIV as well as some key issues across health and social care,” Mr McManus says. “Will NHS England discuss this?”

Time is running out

There are just a few days left to enter the Patient Safety Awards 2016.

The awards will run alongside the Patient Safety Congress, run by HSJ and Nursing Times.

The congress’s main theme will be workforce and sessions will cover subjects including culture change, patient experience, safe staffing, leadership and reducing harm.