Today’s must read health stories and debate

You may experience turbulence

A big part of the NHS planning process in 2016, if it is to be successful, will be about getting people’s backs up. This will be inevitable in getting NHS organisations to properly work together; genuinely cede control; surface awkward disagreements; and make decisions which for some will be negative.

The potential for turbulence hasn’t quite hit home in all areas – particularly for provider chief executives, probably – despite them having to submit sustainability and planning patches by the end of January.

A letter sent by national officials on Tuesday night should have woken up a few more.

It says that each STP patch will have to have a single nominated leader to coordinate their efforts. This will be a “system leadership” role, they say, and should be a chief exec of a provider, CCG or local council.

Areas which decided their STP footprint calmly may now experience a bit more turbulence as they attempt to agree on a boss.

Meanwhile, the list of STP footprints has not yet been finalised.

Negotiations are believed to be ongoing in a handful of difficult areas – most surrounding “success regime” patches, troubled health economies or areas with proposed devolution deals.

Send in the heavies

Amid some lukewarm speculation that some foundation trusts might exercise their freedoms (remember those?) to offer different pay terms and conditions to junior doctors, Jim Mackey, chief executive of NHS Improvement, and Ian Cumming from Health Education England have made sure anyone contemplating such a move remembers who holds the purse strings.

In a letter to chief executives on Tuesday night, Mr Cumming stepped up as the latest national body chief to ensure NHS providers toe the line by warning HEE was “not prepared” to see competition for junior doctors because of variable terms and conditions emerge in the NHS. To hammer home his point, he made clear that HEE would consider the adoption of the new junior doctor contract as a “key criterion” for its decisions on training places investment.

In other words, trusts who don’t adopt the contract could find funding for junior doctor posts removed.

On Monday, Jim Mackey wrote to NHS chief executives and told them NHS Improvement expected the contract to be adopted “consistently” by providers.

Both men criticised abuse one social media against chief executives, following news last week that some hospital leaders have publicly distanced themselve from Sir David Dalton’s letter to Jeremy Hunt that started the ball rolling towards imposition.

Knight round the table

Sir Robert Naylor has already been persuaded to stay on longer as chief executive of University College London Hospitals FT, after it failed to appoint his successor.

Now the NHS’s most in demand knight has been recruited to advise the government on how the NHS can make some money from its underused land and buildings.

If that wasn’t enough, Sir Robert will also lead a programme focusing on NHS land and buildings in London, covering 1,000 acres in the capital.

It comes after Lord Carter predicted that £1bn could be saved by 2019-20 through more efficient use of estates in the acute sector.

His review of hospital efficiency recommended that trusts should plan to operate with a maximum of 35 per cent of non-clinical floor space and 2.5 per cent of unoccupied or underused space by April 2017, and deliver it by April 2020.

The irreplaceable Sir Robert will continue in his role at UCLH and report to health minister Lord Prior, who suggested the work will also help the government meet its “housing ambitions”.

Best play that one carefully though – the ”government selling NHS to private developers” headlines pretty much write themselves.