The must read stories and biggest talking points in health

Special measures risk for London trust

Lewisham and Greenwich Trust in south London could lose more than £6m of income and risk being put into financial special measures after losing a £7.2m contract, a worrying report has found.

The troubled trust stands to lose up to £6.6m of revenue over five years unless Circle, the winner of an MSK services contract for Greenwich, contracts it to deliver community based services and “other orthopaedic activity”, a report by PwC said.

The trust already has a forecast deficit of £34.6m for 2016-17, which puts its finances £14.4m behind plan.

The study warned that the loss of £1.6m of income in the first year of the contract could “add additional financial pressures to the trust”, and lead to “potential intervention, for example being placed into the financial special measure regime”.

The trust told HSJ it was working with Greenwich CCG and Circle “to agree mitigating actions that must be taken by all parties should the trust activity fall beyond planned levels”.

The new provision of MSK services had originally been intended to begin last October, but was delayed until 1 December and then to 1 March to await the report’s findings. The contract has still not gone live.

Pushback over pay rules

Under new Treasury rules, which come into force next month, “off payroll” workers in the public sector will be forced to pay the same level of tax as substantive employees.

The changes will affect interim managers, locum doctors and agency staff who set up personal companies to be paid through, which allow them to limit their tax liability.

Some NHS trusts have been asked to pay higher rates, according to an email from NHS Improvement, seen by HSJ.

The story has been the most talked about on in the last 24 hours, with many readers unhappy with the new rules and NHSI’s approach.

One wrote: “It is a shame that the smaller independents are hit by this change more than the big firms”, while another said: “It is time that the politics of envy were driven out of the NHS and replaced with sound commercial nous, to be honest.”

Immigration charge warning

England’s chief nursing officer has called on the NHS to support European nursing staff as the country prepares for Brexit and the NHS faces a new immigration charge from next month.

Her comments came as the Royal College of Nursing and the British Medical Association called on the home secretary to exempt health and social care from the new immigration skills charge, which is due to come into effect in April. The unions argue the charge of £1,000 per year for a visa will reduce funding for the NHS by more than £5m.

Meanwhile, CNO Jane Cummings said: “Today, around 4 per cent of nurses and midwives in the NHS are from European Union countries. Colleagues from the EU face an uncertain future in coming months. They will need our support. They help represent the communities we care for and we will continue to make them feel welcome.”