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Stability at last?

Worcestershire Acute Hospitals Trust has had a steady turnstile of leaders in recent years, none of whom have stayed long enough to fix the organisation’s long standing difficulties – assuming that is possible.

The winter before last, Jeremy Hunt singled out the West Midlands trust as the one keeping Department of Health officials awake at night. The trust’s performance has improved (slightly) in some areas since then, and deteriorated in others (most notably financially), but overall it remains one of the most challenged hospital trusts in the country.

Sir David Nicholson’s appointment as permanent chair through until 2023 will provide more stability. This month, he will be joined by Matthew Hopkins as chief executive, who is still well regarded despite the difficulties of his time at Barking, Havering and Redbridge University Hospitals Trust. For good measure, Dame Julie Moore has been appointed as “associate non-executive director”, completing what is surely one of the most formidable non-executive groups in England.

The trust now has leadership with deep experience of running hospital trusts, including those in significant difficulty on both quality and financial fronts. Whether the changes at the top will be enough to kickstart a turnaround remains to be seen.

In the long-term plan, which was finally unveiled earlier this week, NHS England indicated community mental health services would become a priority with the promise to introduce national access standards for the service. To its credit, the national commissioner has openly recognised the need to focus and improve community mental health services in its 10 year plan.

But figures in an NHS Benchmarking report, revealed by HSJ, showed the average mental health trust investment in community teams decreased by 20 per cent in real terms from 2012-13 to 2016-17. This suggests NHS England faces an uphill climb – and a steep one at that – if it wishes to achieve its aims.

While this data may only show part of the spending picture, the steady decline of funds going into community services, both mental and physical, is a well known bugbear. Andrew Moore, a member of the Royal College of Psychiatrists’ general adult faculty, told HSJ the findings reflected staff’s experiences, who were “squeezing as much as you can out of the sponge”.

Meanwhile, Miriam Deakin, director of policy and strategy at NHS Providers, described the lack of investment in the “vital” service as “unsustainable at a time when referrals to mental health crisis teams in the community are actually going up”. 

The test for NHS England now will be whether it can turn this trend around in the next five years.