The must read stories and talking points in health policy

Sticky toffee puddings take off

After 10-odd months of intense rumination, sustainability and transformation plans (or sticky toffee puddings, as they are known by leaders in some corners of the nation) seem to be taking off.

Two “full” STP submissions were published yesterday (one only inadvertently). For most of the rest it appears we will have to wait a bit longer.

But local government has taken the opportunity to vocalise ongoing concerns about the fact that social care is a sideshow in the national approach to STPs (compared to saving costs and sorting performance in the NHS); and engagement, including with councillors, has not been a priority.

Disgruntlement among councils and in the care sector are one by-product of two characteristics of the STP process:

First – it has evoked an awful lot of interest and excitement in various arenas and among senior people, not something you can say about all NHS planning/strategising processes.

Second – at times it has been presented as all things to all people. The size of most STP patches lends them to reconfiguring acute and some specialised services, and indeed this was the message sent out about their purpose early on. This gave way, though, to a feeling that STPs had to try to address the problems and priorities of everyone and their dogs: population health, technology adoption, primary care, social care, mental health, etc. All good causes, but raising the hopes that all of these would be sorted risked – and still risks – turning STPs into a turgid process with no tangible output.

The combination of these two made it more or less inevitable that disappointment would follow, and many groups are still trying to get their foot in the door of the STP process.

We suspect, though, that SE1’s leading national NHS quango chief executives will not be altogether alarmed to learn, via council concerns, that STPs have been focusing on making savings from NHS acute services (ie the ones which eat up all the money and where there may be massive savings).

Their nagging concerns – aside from the prospect of political jitters at the very top – are more likely to be about whether STPs will actually succeed in achieving this. On which note, the survey results we revealed today are not enormously assuring: Only one out of 99 clinical commissioning group leaders (chairs and accountable officers) who responded said they had “high” confidence that their STP would deliver its intended aims in 2017-18.

Read more analysis of this striking result here, and watch for more STP developments as they unfold.

Speaking of which…

A new commissioning executive is to be formed to overcome the “significant challenge” of commissioning across an STP footprint in the East of England, and will take powers from seven CCGs.

Revealed in a paper for Oxfordshire CCG’s September board meeting, the new executive will span the CCGs in the Buckinghamshire, Oxfordshire and Berkshire STP. The paper said it was hoped “collective leadership” would secure “better value” from resources and “ensure delivery” of the STP.

Commissioning of ambulance services, NHS 111 contracts, specialised commissioning, prescribing and mental health and acute services will come under the remit of the new board. The paper said other services would be “commissioned together over time”.

Chief executive dismissed

A trust chief executive who has been in post since 1999 has been dismissed for “gross misconduct” after a year long investigation.

Jonathan Parry had been excluded from work at Southport and Ormskirk Hospital Trust since August 2015, due to allegations made by a whistleblower.

The trust has never explained the nature of the allegations against him and three other senior officers who were also excluded. Mr Parry has the right of appeal against the decision.

The trust said: “The announcement follows the outcome of a disciplinary hearing which reviewed 21 allegations of misconduct.

“The disciplinary panel found evidence on 11 counts of misconduct, seven of which amounted to gross misconduct. The panel’s recommendation has been accepted and implemented by the trust board.”