HSJ’s roundup of Monday’s most important stories

Greater Manchester supports its own

CCGs in Greater Manchester have taken ownership of North West Commissioning Support Unit, which is being dismantled this autumn, HSJ revealed on Monday.

It is an interim measure, expected to last until the end of the financial year – but making the arrangement permanent is one of several options on the table for the long term.

NHS leadership capacity is stretched, and constructing a devolved health and social care system for the region is an enormous task. It is sensible to spare the CCGs the effort and disruption of going to market, using NHS England’s “lead provider framework” to choose a new commissioning support supplier, until devolution goes live.

No decision has been taken for the longer term – but the decision to establish a shared function poses a number of important questions:

Why has an exception been made of Greater Manchester – all CCGs were told to go to market earlier this year – and could other groups of CCGs plausibly argue that they too should be allowed a stay of execution?

What if not bringing in an external support provider turns out to be no barrier to successfully establishing a devolved, joined up health and care system for Greater Manchester? What if it actually proves to be an enabler of integration? What if Manchester gets along perfectly well without a CSU or private supplier – where would that leave the case for scaled up commissioning support in general?

Early in 2016 a decision will have to be taken on whether “Greater Manchester Shared Services” – it has a name and a managing director – has a long term future. It will have profound implications for this fledgling market.

The Hunt ultimatum

Jeremy Hunt’s deadline for the British Medical Association and NHS Employers to make progress on negotiations for seven day working is looming. Mr Hunt issued the much publicised ultimatum in July, with a threat to impose a new consultant contract, and it arrives on Friday.

With that in mind, the BMA’s decision to walk away from contract talks last year was “a strategic error”, according to the general secretary of the Hospital Consultants and Specialists Association – another consultants’ union.

Eddie Saville, in a piece for hsj.co.uk, describes his “dismay” at the BMA’s approach of “‘wait and see’ and hoping for a friendlier face in government”. He fears the health secretary will impose a new contract on doctors, after a period “where months of possible engagement on the issue have been lost”.

While the BMA junior doctor committee has decided not to re-enter discussions with NHS Employers, HSJ revealed last month that the doctors’ union and NHS Employers were in “exploratory” talks about resuming negotiations over the consultant contract. Whether this exploring has been successful, we should find out very soon.