Your essential update on health for the week

HSJ Catch Up

This weekly email gives HSJ subscribers a vital update on the biggest stories from the last week in health. If you have been out of the office or just too busy to keep up, HSJ Catch Up will ensure you are still in the know.

CCG mergers confirmed

NHS England has approved mergers consolidating 18 CCGs into six, HSJ revealed on Thursday afternoon.

The national body confirmed its commissioning committee had approved the mergers in principle, to come into force in April 2018.

The move marks the biggest commissioning sector reconfiguration since CCGs were formed in 2013.

The mergers in 2018 are:

The mergers remain dependent on the CCGs meeting several conditions, such as chair and senior management appointments, and a single commissioning and finance strategy.

Cash flow crisis

A severe cash flow crisis has been brewing at a large London trust over the last year, and began rearing its head after suppliers threatened legal action over unpaid bills.

An investigation has been launched into the financial management of Barking, Havering and Redbridge University Hospitals Trust, which has had to draw down a £15m emergency bailout loan from the Department of Health to pay invoices that have been outstanding for more than 90 days.

It is understood some suppliers have been owed money for more than a year, with some threatening to stop deliveries or warning they could take legal action.

NHS Improvement is leading the investigation, with Grant Thornton carrying out an initial review.

Slow response to Grenfell

More than 50 NHS trusts have confirmed they have not had a fire service inspection since the Grenfell Tower disaster – despite all providers being ordered to arrange them just days after the fire.

An HSJ investigation has found that many trusts were told their local fire and rescue services were too busy dealing with higher priority cases to inspect all inpatient facilities, as NHS Improvement had asked to happen following the fire on 14 June.

As a result, at least 54 trusts and FTs have still not had fire safety checks, months after the Grenfell fire.

Although trusts whose buildings had cladding similar to that used on Grenfell Tower have been prioritised for support by NHSI, HSJ has identified several trusts with other types of fire risks that are yet to be fixed.

Of the 172 that replied to our FOI requests, only 95 trusts clearly confirmed that they have had a fire service inspection, while a further five had been partially inspected.

Trust level information from NHS Digital shows that there were nearly 1,500 fires on NHS premises last year, with two fatalities and 35 people injured.

NHS gets tough (ish) on fraud

Making NHS counter-fraud services an independent special health authority has enthused senior management at the former NHS Protect – but it is not clear if it will change anything.

In the complicated picture of who investigates what in NHS fraud, having a standalone body might make things easier by making them simpler.

But critics of the system will point out that the new NHS Counter Fraud Authority, which took on its legal powers on Wednesday, has no more power than NHS Protect had to make improvements to local services.

Most cases are investigated and sent for prosecution by local counter-fraud services, employed by trusts or CCGs.

Currently there are gaps in reporting in some areas that seem… mysterious.

Alongside its three year plan, the CFA presented a breakdown of where unreported fraud may be.

However, with NHS finances tighter than they have been for a decade, trusts have no particular incentive to investigate too thoroughly.

Especially when a balance has to be struck between investigating and potentially shutting down a whole service line for a region.

Vanguard in retreat

It has become clear in recent weeks that the highly praised EMRAD integrated imaging system rolled out across eight hospitals in the East Midlands was not quite the success it was portrayed as.

Clinicians working at hospitals in the region have become increasingly frustrated and worried about the impact of system breakdowns, faults and delays that were hampering their work “on a daily basis”.

Doctors have been raising concerns that images were not viewable and, in some cases, advice by specialists had to be given based solely on paper records.

EMRAD signed a 10-year, £30m contract with GE Healthcare in 2014 to deliver the integrated imaging system, but earlier this week we revealed that the implementation at Leicester had led to a backlog of image reports of more than 30,000. Similar issues were highlighted at Kettering General Hospital last year.

The departure of Leicester from the consortium leaves the mission of integrating a single imaging system across the whole East Midlands impossible to achieve.

Sharing the workforce crisis

NHS England has set each sustainability and transformation partnership a GP recruitment target for 2020.

HSJ has seen the targets given to the 17 STPs in the Midlands and East, which collectively have been tasked with finding 1,300 fully qualified GPs. The national commissoner said it couldn’t share the remaining 27.

The reaction from some hsj.co.uk readers has been one of derision, with a few pointing out that STPs are not statutory bodies with any power to actually recruit GPs – and others claiming NHSE is attempting to “pass the buck” for the increasingly difficult target of finding 5,000 extra doctors by 2020.

What the targets do show is that if NHS England wants to get anywhere near reaching 5,000 GPs in three years’ time, it better get a move on.