The East of England has been doing its annual round of accountability reviews at its primary care trusts. As well as South West Essex, Great Yarmouth and Waveney have had a visit.

Particular concern was attached to James Paget University Hospital Foundation Trust’s reporting procedures. Strategic health authority chair Sarah Boulton wrote that despite “generally minimal” reports of cancelled operations and ambulance queuing, the trust had routinely reported being on “black alert” over a regional capacity management system.

She said: “This is even when their own reported pressures do not show them facing a significantly different situation from other trusts in the area who report a lower alert status. Media releases by the trust citing high levels of cancelled operations were contrary to Department of Health reporting.” The letter said a “backlog” of patients waiting more than 18 weeks for treatment was “a result of inadequate winter planning” by the PCT.

Meanwhile, at the coal face of clinical commissioning, Cambridgeshire Clinical Senate chair Dr Simon Hambling told HSJ the changes to the rules concerning commissioning groups would have a “significant impact” on the region’s plans. Dr Hambling is a member of the Borderline Commissioning Consortium, which currently straddles three local authorities and had planned to enter a fourth.

The government has said commissioning groups should “not normally” cross the boundaries of councils, except where clinically justified. But since Dr Hambling’s patients more often go to Hinchingbrooke he would not be able to use a “patient flows” argument to be in the group centred on Peterborough.