HSJ’s roundup of Friday’s top stories and talking points

Vanguards stifled

The final wave of NHS England’s vanguard service reform pioneers have been revealed.

Thirteen bids have been chosen to take forward projects focusing on collaborations across different acute care providers.

The successful bids include hospital chains – now known as “foundation groups” – and ambitious proposals for accountable clinical networks for cancer, mental health and across multiple specialties.

NHS England chief executive Simon Stevens said in a speech on Friday the era of “go it alone” trusts was being replaced by partnership working across the country.

“We’ve got some of the world’s best hospitals and specialists in this country,” he gushed, “and it’s right they should be able to extend their reach more widely.”

But it would be premature to read the last rites to local hospital autonomy, cautions HSJ’s senior bureau chief Dave West. While the vanguards show a “promising, thoughtful and diverse range of approaches to collaboration”, the number of NHS providers struggling with finance, performance, quality and combinations of the three risks stifling innovation.

He writes: “It’s a common approach for organisations labelled as failing to enter turnaround mode, to put the brakes on adventurous thinking as they try to get a grip of the basics…

“The problem is that the sheer proportion of NHS providers now in trouble means that, as this heads-down approach is adopted, change is being frustrated across swathes of England.”

The incoming chief executive of NHS Improvement will have to give it their all to reverse this problem.

Not close enough for comfort

It’s been a tough fortnight for Keith McNeil, who resigned from Cambridge University Hospitals Foundation Trust last week shortly before a damning Care Quality Commission report placed the trust in special measures.

Dr McNeil had taken some comfort from the support of the trust’s consultant body, which announced last week prior to the CQC report’s publication that they would hold a vote to call for the ex-leader’s reinstatement.

In an interview with HSJ on Friday, Dr McNeil said he was concerned his departure would deter clinicians from “putting their hands up to do jobs like mine or any senior leadership roles”, before adding: “The majority of the consultants at Addenbrooke’s don’t want me to go.”

In the meantime the CQC report was published, which, when it appeared, included criticisms of the trust’s leadership and noted there was a “disconnect” between senior management and frontline staff.

This seems to have given some consultants a moment’s pause. An email from the chair of the consultant committee, seen by us, said: “Consultants might well feel differently when they read the full report. Now we have the CQC report and have had some chance to read it I think that might have changed some people’s minds.”

In the end, the committee decided the result was not conclusive enough to call for Dr McNeil’s reinstatement, with only 52 per cent of the consultant body placing votes and 70 per cent of those in favour of reinstatement.