Daily Insight: Trusts plan future 2gether

Wild South West

Wednesday was a big day for Dorset’s NHS as the clinical commissioning group met to decide on a host of proposals that will shape services over the next decade.

The most controversial element was the CCG’s plan to centralise emergency and elective services at Royal Bournemouth and Poole hospitals respectively.

Chiefs in Poole were resigned to losing their emergency department last year, when the CCG made Bournemouth its preferred choice for a major emergency hospital.

But the plans, part of a clinical services review, prompted a predictably angry reaction from residents and NHS campaign groups.

Nine petitions were handed in with 75,000 signatures, and protests have been a feature of the process.

The CCG even hired three security guards for today’s meeting, according to the Bournemouth Daily Echo, but the event appeared to pass smoothly – as did all the recommendations put in front of the governing body.

As well as the split between emergency and elective care, the decision means maternity and paediatric services will be centralised at Royal Bournemouth – with more work needed in the west of the county to find a sustainable maternity model.

New mental health walk-in facilities will be set up, as well as community hubs to bring care closer to patients’ homes.

Further west, two small trusts have announced plans to merge.

Gloucester based 2gether Foundation Trust and Gloucestershire Care Trust are set to appoint a joint chief executive and chair by December.

While it’s early to speculate on the implications of this, it does mean an end to the trust whose unusual name prompted NHS England to issue guidance about what NHS organisations should be called.

Movers and shakers

Some signicant arrivals and departures to report from Wednesday.

First, Glenn Douglas, longstanding chief executive of Maidstone and Tunbridge Wells Trust, is leaving to run the Kent and Medway STP full time. Mr Douglas has led the trust since 2007 and was the senior responsible officer for the STP part-time since it was set up last year.

He was brought in after a serious C diff outbreak and a damning report from regulators. Although the trust has sometimes struggled financially over the past decade, he has overseen the successful centralisation of services at a new hospital and the restoration of the trust’s reputation locally.

Meanwhile, Locala Community Partnerships’ chief executive Robert Flack will stand down at the end of the month. Mr Flack’s sudden resignation follows the Care Quality Commission rating Locala’s community health services for adults and community inpatient services inadequate in May. Mr Flack said he was leaving to “explore new career opportunities”.

Finally, former chief inspector of hospitals Professor Sir Mike Richards will join consultancy Incisive Health as a senior counsel next month.

Kirkup’s return

Concerns over the NHS’s mishandling of long running poor care cases are nothing new… and there is no more obvious example than the appalling, 16-year battle fought by the parents of baby Elizabeth Dixon.

After her story was highlighted by HSJ, her parents are finally about to see the start of an independent investigation by the former chair of the Morecambe Bay inquiry, Bill Kirkup.

He has promised to go where the evidence takes him and has made clear in his terms of reference and comments to us that he will look at the regulatory response to the case and whether national bodies effectively discharged their duties.

In 2014, NHS England and the CQC were planning a joint investigation into Lizzie’s treatment but Simon Stevens pulled NHS England out of the work while Lizzie’s parents were travelling on a train to London to hear details of the investigation.

What followed was a shambles. The CQC was unable to progress despite wanting to because it lacks the power to investigate individual cases. The Parliamentary and Health Service Ombudsman, which agreed to examine the case after intervention by HSJ and the Department of Health, refused to investigate nine months later.

Eventually, the health secretary stepped in to order the inquiry Dr Kirkup will lead.

As well as getting to the bottom of what happened to Lizzie, Dr Kirkup will hopefully hold to account the national bodies which appeared to shirk their responsibilities, and make recommendations for changes to help other families still fighting for justice.