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Special measure’s merry-go-round

It has been a busy week for the Care Quality Commission, with four trusts entering special measures in six days.

Two were first timers – Kettering General Hospital Foundation Trust, which HSJ had previously reported was in trouble, and the Isle of Wight Trust.

Two were original Keogh trusts re-entering special measures: United Lincolnshire Hospitals Trust and Northern Lincolnshire and Goole Hospitals FT. Both are in central and north Lincolnshire, suggesting that the struggling providers may not just be dealing with poor leadership or beleaguered staff, but systemic issues specific to the local health economy.

While the CQC is adamant that there is no special measures quota or limit, there appeared to be a clearing of the decks at the start of the year. Five trusts between January and March left the special measures regime, one of which, East Kent Hospitals University FT, was cleared for exit by the CQC in December but unusually there was a three month delay in ratifying the decision by NHS Improvement.

So since January it’s five out, four in.

The NHS starts the 2017-18 financial year with 15 trusts in special measures, and although different trusts have entered and exited, it started 2016-17 with 16 trusts the programme.

Cheshire united

Four clinical commissioning groups in the North West plan to establish a “unified health commissioner” that could lead to a formal merger of the organisations.

The accountable officers for West Cheshire, South Cheshire, Vale Royal and Eastern Cheshire CCGs have agreed a joint committee should be created as a first step, with their governing bodies being asked to approve the plans this month.

These are the latest CCGs in the region looking to merge or create shared leadership committees, following groups in Manchester and Merseyside.

The plans were explained in a public board paper for South Cheshire and Vale Royal CCGs, which said the county’s current commissioning arrangements “often resulted in delays in decision making” and “variation in decisions and approach taken”.

However, the document adds: “Any decision to merge the CCGs must be taken and led by the GP membership of each CCG.”

South Cheshire and Vale Royal CCGs already share an accountable officer, Simon Whitehouse, and have had merger ambitions since 2015.