HSJ’s roundup of the day’s essential stories and debate

A step back for devolution

“Devo Manc” might have to be renamed “dele-Manc”, because for all the pomp and ceremony that surrounded the Greater Manchester devolution agreement last year, many of the budgets are being devolved not to local leaders – but delegated to the region’s new chief officer.

Who will be employed by NHS England.

Half the12 budgets being “devolved” will be the responsibility of the Greater Manchester chief officer.

While the devolution programme’s chief officer, Ian Williamson, insisted the arrangements are “consistent with what we set out to do by this point”, Richard Humphries of the King’s Fund argued that “NHS England will remain very tightly in control of the purse strings… it’s not keeping pace” with the project’s ambitions.

HSJ editor Alastair McLellan observed last year that “by far the most interesting aspect” of the Manchester policy was not the handing over of budgets, but the “plans on issues such as priority setting that could have profound impact elsewhere”.

We also saw this playing out on Wednesday.

A number of councils and clinical commissioning groups across Greater Manchester are being encouraged to “create one commissioning organisation”, with talks in Bury and the city of Manchester already taking place.

The editor said today the “real opportunity of devo Manc is to unpick the Lansley reforms”. Perhaps it that process starts in Bury.

The NHS trendsetter

Last week, Frimley Health chief executive Sir Andrew Morris declared the NHS should do trust takeovers on a “bigger scale”, when the circumstances were right. This followed the CQC saying Wexham Park Hospital’s improvement since Frimley Health acquired it was the “most impressive” it had ever seen.

As HSJ said in our latest leader: “Sir Andrew has never been one for following fashion and firmly rejects the conventional wisdom that trust mergers do not work.”

He warned “we’ve still got too many organisations on the provider and commissioning side of the NHS”, while the editorial called for bold leaders to spread their wings:

“These are tough times for the NHS and those trust chief executives who have built a reputation for excellence within a single organisation or locality need to take the risk and extend their influence.”

But Sir Andrew is becoming a trendsetter quicker than first thought.

On Wednesday, Calderstones Partnership chief executive Mark Hindle told HSJ: “There should be more mergers to create organisations that are strong and sustainable, and I think we’re a good example of what can be achieved.”

Calderstones is set to merge with Mersey Care Trust in July, and has already been working with the trust to raise its CQC rating to a “good”.

Mr Hindle added: “I think [mergers] probably need to come into fashion more, but it’s critical that boards aren’t forced into it.”

Mersey Care’s Joe Rafferty agreed: “I say there is room for more [mergers] although it’s not an automatic solution.”