The most important stories in health policy today
Stay of execution
Documents started to circulate late last year suggesting NHS Improvement was looking at bringing in external consultants to help with a major bit of work – putting up to 25 trusts into turnaround.
A lot of other things have been going on in the set-up of the Monitor/TDA composite so it’s maybe not a surprise a decision on this has been deferred.
But the body says it is still looking at approving the move, the scale of which might preclude some smaller independent bidding for the contract.
Putting trusts in turnaround would be a significant step and risks damaging relationships between NHS Improvement and the providers it must help/cajole back into balance over the next 14 months.
The move would also raise questions about the efficacy of the many existing tools the centre has to hand: chains, special measures, “buddying”, the success regime, merger and acquisition, enforcement undertakings.
A wave of external consultants arriving in low-morale organisations could also be a bit galling for organisations already coping with worst-ever finances. Trusts have also been grappling with a January that was significantly tougher than the mild December the service enjoyed.
Too early to call the success regime a failure?
Last week Simon Stevens defended the name “success regime” from sceptical MPs at the public accounts committee. Soon he may have to defend their actual performance.
Set up in June, the three success regimes across England are essentially a concentration of central governance power, able to order local leaders to address fundamental health economy problems.
They are explicitly about working across organisational boundaries, and implicitly seek to avoid another Lewisham, where a rogue CCG and the High Court combined to scupper an A&E closure.
At NHS Improvement’s debut board meeting chief executive Jim Mackey said the three areas could have made more progress in the six months since their birth.
With contractors like these…
Experts by experience are people with personal experience of health and social care services employed to bring a service user perspective to CQC inspections.
Late last year the regulator awarded contracts to Remploy and Choice Support to provide and manage future experts.
The CQC’s troubles started when it emerged that Remploy, which is majority owned by the US firm Maximus, was planning to cut the experts’ pay by about 50 per cent – from £17 per hour to £9.40 in London and £8.25 elsewhere. Unsurprisingly, many of those affected expressed outrage at the proposal.
The regulator was slow to react to the developing controversy because it is still locked in contractual negotiations with its new suppliers, but yesterday it announced that any experts by experience transferring to Remploy would get an hourly rate of £15 for the first six months of the contract, followed by six months at £12.50.
However there has not yet been any word on long term pay rates. One expert by experience, who has said she attends to quit, described the latest offer as “a sliding scale of insult and uncertainty”.
It appears the CQC will have to do more to put the lid on this controversy.