The must-read stories and debate in health policy and leadership.

London weighting

Leafy Kingston-upon-Thames is a far cry from the high cost high rises in London Bridge or Chelsea’s whitewashed town houses. But that doesn’t mean the cost of living is any less.

So says Ann Radmore, chief executive of Kingston Hospital Foundation Trust, who wants to redesign the “doughnut” salary supplement that sees staff in the centre of London get a 20 per cent addition to their salary, while staff in the outer boroughs get 15 per cent.

This “London weighting” is meant to make it easier for NHS staff to live and work in the middle of one of the world’s most expensive cities.

But Ms Radmore says it’s time the supplement acknowledged that living in Richmond is just as pricey as the centre of town. She wants the weighting to be a flat rate across the capital.

Unsurprisingly, she says her colleagues running trusts in London’s outer boroughs are keen on getting a little more money for their staff. Central London providers will clearly be more circumspect: they definitely won’t want to see their staff supplement cut to distribute more to the suburbs.

Stretching creditors

By stretching out their invoice payments, NHS trusts have released some of the pressure on cash flows and in some cases avoided the need for bailout support.

But as former NHS Improvement chief executive Jim Mackey warned, these tactics can have serious consequences for suppliers, some of which are small and medium sized businesses, which are heavily dependent on the NHS to maintain their own liquidity.

Oxford University Hospitals Foundation Trust set out these risks in stark terms in some committee papers, as it opted to slow down invoice payments (while sticking within the statutory 30 days).

Among those cited were a “significant risk of damaging supplier relations” and “risk of supplier bankruptcy”.

Asked to what extent the risks have materialised, the trust said: “On occasion since implementation the ending of deliberate early payment has resulted in some suppliers being paid later due to administrative errors. These issues are dealt with on a case by case basis and payments are made to suppliers to rectify any unintended late payment.”