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Dispute over delays

Recent negotiations between the West Midlands Ambulance Services and CCGs could be a sign that the 2017-18 contracting round didn’t go as smoothly as everyone thought it might have.

According to a director at the WMAS, the beleaguered trust demanded that its 22 CCGs recognise the impact of patient handover delays on its pocket.

Its demands included a second full tariff payment for delays over 60 minutes and payment for delays over 30 minutes.

Speaking to HSJ, clinical commissioning and service development director Mark Docherty said these demands were driven by the need to reduce long handover delays across the area. WMAS’s own calculations suggest handover delays are costing it up to £4m a year.

The biggest culprits, according to Mr Docherty, have been Worcestershire Acute Trust and Shrewsbury and Telford Trust – trusts that also have long planned and much delayed service reconfigurations pending.

In light of the £6m hole it would have made in their combined budgets, however, the CCGs refused to meet the trust’s demands.

Following mediation, the CCGs agreed to pay the trust £1.1m in addition to the £1m already promised.

The trust told HSJ that this was not the agreement it would have liked.

Former trust chief on trial

The trial of former trust chief executive Paula Vasco-Knight is scheduled to begin on Tuesday.

Ms Vasco-Knight, who was Torbay and South Devon Healthcare Foundation Trust chief executive from 2008 to 2014, pleaded not guilty to three separate counts of fraud at Exeter Crown Court last June. From 2012 to 2014 she was also national equalities lead for NHS England.

The charges relate to a period between October 2012 and August 2013. Stephen Vasco-Knight, of the same address in Runcorn, Cheshire, also pleaded not guilty to one count of fraud.

Habib Naqvi, who was NHS England equality lead, is also standing trial for three counts of assisting in the commission of an offence in breach of the Serious Crime Act 2007. He pleaded not guilty to the charges.

A jury was sworn at Exeter Crown Court on Monday morning but the case was adjourned until Tuesday, when the defendants will be back in court.

Threat to care in the home

Thousands of patients could be forced into residential care as a result of CCGs restricting funding for care at home, data shared with HSJ reveals.

Thirty-seven CCGs have set cost restrictions on NHS Continuing Healthcare funding, which pays for ongoing care for adults who are assessed as having a primary medical care need. It is arranged and funded solely by the NHS.

Nineteen CCGs have said they will not fund care in a person’s own home if the cost is more than 10 per cent above that of an “alternative option”, which is normally a residential care home placement. A further seven CCGs have set cost caps between 20 and 40 per cent above care home fees.

Eleven commissioners have said they will restrict the cost of individual Continuing Healthcare funding but have not set a precise cap.

The latest Continuing Healthcare eligibility figures from NHS Digital suggests up to 13,018 people may be affected by the restricted funding policies in the 37 CCG areas.