HSJ’s roundup of Friday’s key stories


Cornwall is expected to follow in the footsteps of Greater Manchester as the second region in England to sign an integration/devolution deal, including greater control of health and social care spending.

The county’s own plans include aiming to jointly manage a £2bn pooled budget, combining health, welfare and social care spending, by the end of the decade.

Chancellor George Osborne is expected to announce the deal when he delivers the emergency budget next Wednesday - making Cornwall the first area outside of a major city to win a devolution deal. Undoubtedly the rural, less populous setting - and the presence of only one council and CCG - will mean the approach is substantially different from Greater Manchester.

Full details are still to be finalised, but HSJ understands that the plans for commissioning integration are seen as complementary to existing proposals to achieve greater integration between health providers.

End of an era

One of NHS England’s most senior figures will retire by the end of the year.

Dame Barbara Hakin will leave her post as the organisation’s national commissioning operations director, which she has held since its formation in 2012.

An appointment is expected to be made to “a reshaped national director role” in coming months.

Dame Barbara currently oversees NHS England’s regional and area teams. Her responsibilities have previously included operational performance and the development of clinical commissioning groups.

She has worked in the NHS for 41 years, including stints as the chief executive of the East Midlands Strategic Health Authority, and of primary care trusts in Bradford. She was a GP in Bradford for more than 20 years before entering full time management.

HSJ editor Alastair McLellan tweeted:

Eroding freedom

There has been a heated reaction to comments made by David Bennett. The Monitor chief executive said foundation trusts could see their freedoms “completely eroded” if they not do better to reduce a sector-wide deficit projected to reach £1bn in 2015-16.

Below the line, Labour peer Philip Hunt had plenty of questions for Mr Bennett: “How? By cutting patient staff ratios? Must rank as the most absurd statement yet by this hopeless organisation. What is it for?”

Other readers pinned blame on the much-maligned tariff system.

One said this approach “would be fine if FTs were allowed to set their own prices”, but current tariffs “and the approach to local tariff setting (ie what CCGs can afford rather than what the service costs to provide)” mean it is “pretty much impossible for most FTs to make money unless they have very significant non NHS sources of incomes”.

“Perhaps setting a tariff which actually covers the cost of healthcare delivery might help,” another reader suggested.