HSJ’s round-up of Friday’s essential health stories and debate

Essex’s leader in chief

The NHS does not have a good history of mergers, but system leaders are still very keen to experiment with variations on the theme.

The three hospital trusts in mid and south Essex success regime are the latest to look into a “collaborative model” that does not involve a full merger.

They are establishing what internal documents seen by HSJ refer to as a “group model”, which involves the three trusts being run as a “network” of hospitals with a flexible workforce.

The three trusts, which have combined revenues of £840m, are Basildon and Thurrock University Hospitals FT, Southend University Hospital FT; and Mid Essex Hospital Services Trust.

On Friday, we learned that Basildon chief executive Clare Panniker is to head up the new leadership team, with the job title “lead chief executive”.

Her brief is to drive “collaboration between the three hospitals [in order to] improve staffing levels in some specialties, reduce duplication and costs and improve outcomes for patients”.

A statement by the trusts said the project was part of wider success regime plans to rebalance the health economy by 2018-19 – a heroic task in light of its projected £216m deficit within that period.

Ms Panniker is a well regarded chief executive who was number eight HSJ’s Top Chief Executives power list this year.

But she and her leadership colleagues (the details on which are still being decided) have a very significant challenge on their hands if they are going to drive the kind of radical reconfiguration required to make the health economy sustainable.

The governance structure for the unprecedented new arrangements will be a critical component to deciding how much influence the new group will have.

HSJ understands that because the group involves two foundation trusts and an NHS trust, the governance and assurance arrangements are even more complex that would have been the case if they were a homogenous group.

The details on this are still being worked out. In short: there is much to do to make this project credible.

Restricted access

Three CCGs in Worcestershire are seeking feedback on proposals for extensive restrictions to NHS services.

The list of services which Redditch and Bromsgrove, South Worcestershire and Wyre Forest CCGs are thinking about restricting is a long one, ranging from physiotherapy to vasectomies via gluten free food prescriptions and hearing aids. They are aimed at closing a £25m funding gap next year.

If the CCGs go through with the restrictions (they stress that they are just ideas and no decisions have been made) then they will follow commissioners in Essex and Staffordshire who have already implemented “rationing” policies.

Pity poor NEW Devon CCG – when they outlined similar plans in December 2014 it was national news, and the group ended up getting slapped down by government ministers and even the NHS England, chief executive, Simon Stevens.

In the post-election period CCGs appear to have more freedom to cut their cloth.

However, it’s not all cuts – the CCGs suggest ideas about how primary care could change to reduce unnecessary accident and emergency visits.

Whatever their final decision, they will have to ensure it is consistent. The survey also suggests reducing the opening hours of minor injury units, which if managed badly would surely send more people to A&E.