HSJ’s round-up of Wednesday’s must read stories and debate

Trusts get moving on efficiency

Last month, NHS Improvement chief executive Jim Mackey and chair Ed Smith wrote to every trust chief executive telling them to begin planning for consolidating back office and pathology services, and “unsustainable” planned care services.

On Tuesday evening, the next NHSI missive landed – a letter from deputy chief executive Bob Alexander setting out how these plans should be worked up.

The bad news is that health leaders only have a few working days to submit their proposals before the 31 July deadline.

The good news is that NHS Improvement is not expecting War and Peace – the consolidation plans only have to be “two page notes”.

Two page proposals expected to be turned around in eight working days could be the very definition of a “quick and dirty” plan to get the NHS out of its financial hole.

NHS Improvement would probably defend the tight timescale by pointing out that it’s asking for high level plans they can kick the tyres on, and that trusts have had since the 2008 Carter review to get their act together on pathology consolidation.

It has also specifically picked back-office, pathology and planned care services because of their supposedly uncontroversial nature. The NHS needs to make savings fast, so there is little appetite to get bogged down in politically sensitive and interminable A&E and maternity reconfigurations.

Still, whether trusts are able to put worthwhile plans to paper in eight days is an open question. One anonymous provider source bemoaned the “superficiality” of what could be achieved in that timeframe.

New care model contract dispute

Last week HSJ reported how Dudley was the first multispecialty community provider vanguard to set out how it plans to set up the new type of provider, revealing details of how the organisation might look. Notably there will be a “single legal entity” holding one contract with the CCG

Well, on Wednesday, it appeared that not everyone in the town is happy about how this milestone was reached.

Paula Clark, chief executive of Dudley Group Foundation Trust, told us that Dudley CCG’s plans for the contract “pose significant risks” to its future.

The plans state that £78m of Dudley Group’s services will fall under the new MCP contract, £27m of which will be directly provided by the MCP contract holder and £51m subcontracted back to the trust.

Ms Clark said: “If the trust loses £77m of revenue from being unsuccessful in bidding for the MCP contract it will pose significant risks to the future of the organisation both clinically and financially.” She also suggested an alliance contract model with a lead provider would be a better alternative.

In response, CCG chief officer Paul Maubach said: “The MCP brings primary, community, mental health and social care services together to establish our model of care to meet the needs of Dudley people.

“This places population need and the model of care over the interests of any individual provider but we also have a system-wide partnership with all providers to ensure that any risks, as well as opportunities, are addressed as a system.”

Manchester mergers

Ever-ambitious health leaders in Manchester will aim to create a single provider of out of hospital services by April 2017, as well as merging two major teaching trusts.

A “local care organisation” (or LCO), which would hold a single contract for all non-acute care, would encompass community services, social care, prescribing and public health services.

HSJ has previously reported on the plans to merge Central Manchester University Hospitals Foundation Trust and University Hospital of South Manchester FT, also by April 2017. Under the plans, the merged organisation would not take on the community services currently run by the trusts.