HSJ’s roundup of the must read stories and debate on Friday

Warning from the top

It’s fairly unusual for national chiefs to publicly wade into local NHS debates, but Simon Stevens was clearly keen to make a point after a critical court decision in Greater Manchester this week.

As revealed on Thursday, a high court judgement has backed commissioners decision to remove emergency and high risk general surgery from Wythenshawe, which is run by University Hospital of South Manchester Foundation Trust.

While local leaders made conciliatory statements about the judicial review being brought out of concern for patients, Mr Stevens launched a pretty pointed attack on the trust and its staff, saying spurious claims were made to advance a “mistakenly conceived institutional self-interest”.

The court decision will be a major relief to local and national leaders, as the Healthier Together shake-up is seen a key pillar of the devolution plan. And with much reconfiguration now expected across the country, NHS England will surely hope the case will deter hospitals and their clinicians from resorting to court action.

Mr Stevens said: “[This] result rejects the spurious claim that better emergency care for patients in Greater Manchester, Derbyshire and Cheshire should have been sacrificed to advance one hospital’s mistakenly conceived institutional self-interest.

“That’s a wider lesson that the whole of the NHS will need to learn from, as we kick off the process for developing shared sustainability and transformation plans locally to implement the Five Year Forward View.”

The attack received a mixed reaction from HSJ readers, with one saying it was “a tad unseemly for the NHS chief executive to crow victory and warn others”.

But another agreed with Mr Stevens, saying: “Institutional self-interest is rife in the NHS, and is frequently the dominant (but unspoken) value exhibited by boards.”

Pre-strike action

While junior doctors are touching up their their placards ahead of Tuesday’s strike, HSJ revealed on Friday that their senior colleagues are close to a final deal on reform to consultant contracts.

According to sources with knowledge of the talks, negotiations came to an end shortly before Christmas with a final negotiating document sent to the Department of Health for costing and approval.

A final offer will then be presented to the full consultants committee at the British Medical Association later this month with a full vote of the consultant body in February.

HSJ understands the deal will allow both sides to claim some victories. Ministers will be able to say the deal makes it possible for hospitals to have greater numbers of consultants available at weekends and evenings, while the BMA can say it has delivered higher earnings sooner for consultants – who will benefit from an improved career average pension.

However, it is not certain that any deal will be approved by consultants. The cost neutral approach, which means some consultants will financially lose out while others benefit, could make a vote on the contract difficult to predict, HSJ has been told.

One source said the inclusion of senior registrars in the vote and the tensions over the junior doctors’ dispute could not be ignored. “There is a concern that this could split the membership and the absolute worst outcome for consultants would be a narrow rejection of the offer,” the source added.