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Tough takeover

Nottingham University Hospitals Trust’s takeover of a treatment centre previously run by Circle has been far from straightforward and there could be yet more trouble ahead.

A group of doctors who provided ad-hoc sessional work at the treatment centre under the private healthcare provider are, according to a source close to the centre, not keen to work under NHS terms and conditions.

Concerns about working under the NHS’ conditions include possible negative tax and pension implications and the trust has confirmed the national pensions crisis has influenced its conversations with this group.

The trust has set out transitional arrangements for the group for the next three months, during which they will still be able to provide services under a limited liability partnership model. However, as the trust’s preference is for them to become substantive employees, it’s unclear how many will want to sign up to this. 

Norfolk and Norwich University Hospitals Foundation Trust’s prospective chief executive Sam Higginson will have a full in-tray when he takes up the role in the autumn.

But, with a new leadership duo in place (David White replaced John Fry as chair in April) and a good slug of capital funding signed off this week, the trust has a golden opportunity to move on from a hugely challenging period and hoist itself out of special measures.

Mr Higginson joins from his role as chief operating officer at neighborouring Cambridge University Hospitals FT, so is well versed in the challenges facing a large tertiary centre short on capacity and serving a financially challenged system.

Mr Higginson also no doubt learned how to think on his feet in his life before the NHS when he worked with UNICEF as a UN logistics officer coordinating the airlift of emergency supplies in Sudan.

At NNUH, he replaces Mark Davies, who announced he was stepping down in January after four challenging years. During Mr Davies’ tenure, the Care Quality Commission judged the trust had failed to get on top of its leadership, cultural and performance problems, and NHS Improvement raised fundamental concerns about its finances.

It would be unfair to lay the blame for this all at the former chief executive’s door. The problems were already there when he joined in 2015, suggesting they are deeply systemic.

And, while he did not deliver the leadership, cultural and performance transformation the trust desperately needs, there have been signs of improvement. The CQC upgraded the trust from “inadequate” to “requires improvement” in May, although it remains in special measures.

The management has also managed to secure capital funding for much needed expansion and upgrades. The trust was one of 20 providers given the green light for capital projects as part of a controversial announcement about upgrading NHS hospitals by new prime minister Boris Johnson last Sunday.