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

Banker needed

On the face of it, GP federations are an ideal fit to the administrative demands of primary care networks.

The networks will get new money from NHS England, for example, to reimburse most of the salaries of their new staff. To take in the cash, the networks need to have one of their members set up to act as a banker.

For some of the nascent PCNs, this will not be much of a problem – they have a network member who is ready to look after other people’s money and deal with the accountancy and governance challenges that come with it.

But others felt their local GP federation would be better placed to handle any legal road bumps or tax quibbles. Unfortunately, the rules for PCNs, set out by NHS England in April, complicated this.

HSJ understands NSHE is working with commissioners and partners in primary care to clarify that GP federations can perform the role.

Not a moment too soon. On 15 May, PCNs had to submit their registration paperwork to their commissioners. In it, they had to include the bank details for their network’s fund holder.

A troubled trio

Norfolk remains special measures country following its latest visit from the Care Quality Commission.

This time it was the turn of its long-troubled tertiary provider Norfolk and Norwich University Hospital Foundation Trust.

The hospital’s overall rating was lifted from “inadequate” to “requires improvement”. But the provider will remain in special measures and ongoing cultural problems in its emergency department continue to blot the copy book.

Norfolk’s mental health provider, Norfolk and Suffolk FT, and one of its two district general hospital providers, Queen Elizabeth Hospital King’s Lynn FT, are also in special measures. This means an unprecedented three providers in the county are in the improvement regime. 

So, what to do? The trust is set to change both its chief executive and chair in the coming months.

David White, currently chairman of East Suffolk and North Essex FT, will join the trust shortly and is charged with selecting a new chief executive.

The new leadership team may well be able to boost performance across the organisation, but it is unlikely they will be able to do so without significant support from regional and national partners, such is the depth of the problems in Norfolk. 

The private finance initiative hospital, despite being built in 2001, is woefully short of capacity (the trust estimates it needs 200 more beds). But the poor financial performance, driven in part by the costs of the PFI, means it cannot easily get hold of capital to address this.

The trust said it was on a journey to be outstanding in five years. This will simply not happen without significant investment.