The must-read stories and debate in health policy and leadership.

Getting closer

North east London could soon have a joint chief executive and chair running Barking, Havering and Redbridge University Hospitals Trust and North East London Foundation Trust, in part of regional director Sir David Sloman’s drive to reduce the potential and actual barriers to integration across the capital.

The move follows a review commissioned by joint chair Joe Fielder and authored by Sir David Dalton, who led the creation of the Northern Care Alliance in Manchester.

But, while leadership teams at the two trusts have agreed to a joint chief executive, they appeared to have stopped short – for now, at least – of following Sir David’s recommendation of an entirely shared board, and a regional management team for each of the three boroughs, including all NHS services (including primary care) as well as social services.

So, while it is not a full merger, the group model (one version of which was led by Sir David Sloman before he moved to the regional office) is being pursued in a new part of the capital.

North East London FT has a strong track record of bidding for and winning tenders to provide services outside of north east London and has been at pains to stress this work will not be affected by teaming up with BHRUT.

Whether a shared chief executive will have much bandwidth for the further-flung parts of the NELFT empire when they are contending with some of the consultants at BHRUT remains to be seen.

Caught in the middle

It is well known that autism services across the country are hit and miss. HSJ’s story this week shows how patients can get caught in the middle between provider and commissioner mishaps.

Last week, Midlands Psychology, a children’s autism services provider for South Staffordshire, warned the families it provides support to that it intended to cancel non-urgent services.

Its reasoning for this was that the area’s clinical commissioning groups had allegedly given it just a month’s notice its contract would not be extended.

The CCGs have been planning to retender their autism services, following a critical external report of the area’s autism and children and adolescent mental health services. However, this tender process will be finalised in January, while Midland Psychology’s contract ends on 30 September.

Midlands Psychology’s chief executive claims the provider was under the impression it would be granted an extension up until January, giving it time to hand the contract over. It is not clear whether this was the case, but the provider argues it would not have time to adequately prepare for handover while also providing business as usual.

The CCGs, however, say Midlands Psychology is contractually obliged to provide services until 30 September.

Regardless of what has happened behind the scenes, the events will have no doubt caused alarm and distress for patients. If lessons can be learned from these events, perhaps it is to communicate with service users earlier in the game.