Imperial College Healthcare Trust plans to launch a new academic health science partnership covering north-west London - but its architects insist Imperial’s existing AHSC will continue to function alongside the new body.
HSJ has obtained Lord Ara Darzi’s review of the existing Imperial AHSC - the first of five partnerships in the country between teaching hospitals and medical schools - which saw its chief executive leave as the trust sank into deficit.
It backs the creation of a new scheme, planned for launch next April. It envisages the adoption of the sort of partnership model employed by fellow London AHSCs King’s Health Partners and University College London Partners, rather than the centralised leadership-style of Imperial’s existing AHSC.
However, the paper says the plan is “not about redefining the existing academic health science centre”.
The AHSC review said: “This paper does not seek to impose a model defined by Imperial on to other healthcare and academic institutions in north west London, rather it defines a set of principles on how we could work together, and charts a path forward.”
It promises “equal shares and equal power for all” but suggested the new entity be called “Imperial Health Partners”.
In his conclusion Lord Darzi said: “This is precisely the right moment to pursue such an ambition.
“The NHS faces a stark choice, it can either return to what it knows best, incrementally reducing services and allowing waiting lists to grow, or it can embrace the transformation of health services for the population. This implies an important choice for all NHS and higher education organisations in north west London: Do they face the storm alone or standing in solidarity?”
His report sets out a “spectrum” of potential collaboration for trusts, ranging from individual autonomy with shared learning to full organisational integration, with “revenue lines merged and partners sharing in any profits”.
Alongside this option, ”they can rationalise their asset base to maximise its effectiveness. This would imply a single service across multiple sites and participating organisations”.
The collective provision of services across north west London backed by Lord Darzi could potentially solve some of the problems faced by individual trusts.
The Royal Brompton and Harefield Foundation Trust is currently challenging the legality of a consultation that excluded it from a list of trusts in London allowed to perform paediatric cardiac surgery – while including two other units, both of which are members of London’s other two AHSCs.
Imperial College Healthcare Trust is reviewing its estate usage alongside West Middlesex University Hospital after a widespread acceptance that its sites need to be consolidated.
Lord Darzi said membership of the partnership should be open to all providers and academic institutions but he “does not believe it is appropriate for clinical commissioning groups to participate”. He adds: “It is important the partnership does not become a forum for commissioner-provider negotiations.”
He added that after “observing other AHS partnerships” the new organisation would have an annual budget of between £3m and £5m.
His review said: “In 2009 new academic health science centres and partnerships were founded. Different organisations took fundamentally different approaches. Though described as different models – federated versus integrated, for example – they were in fact fundamentally different propositions. For the partnerships, the goal was to scale up on a whole population basis the evidence base for high quality care – with the emphasis on scale rather than speed. For the integrated model, the goal was to move at pace to bring new practice from the bench to the bedside.”
Joint chief executive of Imperial College Healthcare Trust and Pro Rector (Health) at Imperial College London Steve Smith resigned in April. The trust is predicting a £35m deficit this year.
Before leaving Professor Smith wrote to the Department of Health warning of the “potential damage to [Britain’s] wealth creating potential arising from the special problems faced by AHSCs”.
“The ability of the UK to compete in the biomedical and biotechnical industries is dependent on the success of research, active higher education institutions and their interaction with the NHS, epitomised by the AHSCs,” he wrote.