Your essential update on the week in health

HSJ Catch Up

This new 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 otherwise too busy too busy to keep up, HSJ Catch Up will ensure you are still in the know.

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HSJ calls for ‘top-down reorganisation’ of CCGs…

It’s time for “top-down reorganisation” of clinical commissioning groups, argued HSJ editor Alastair McLellan in an editorial published on Monday.

He wrote: “The creation of [sustainability and transformation plans] stems from a clear eyed recognition by NHS England that clinical commissioning groups are unable to fix the underlying problems affecting most health economies.

He added that “many CCGs are not strong”, and it has been a challenge for every CCG to find good quality chairs, accountable officers and finance directors – “which is why you end up with a tiny and struggling CCG spending £500,000 on two interim directors”.

…as Birmingham CCGs consider joining forces

In Tuesday’s Daily Insight, we revealed that moves were happening in Birmingham towards a full merger of three CCGs in the city and Solihull, or at least a major step in that direction.

HSJ published more details on Wednesday: Birmingham South Central, Birmingham CrossCity, and Solihull CCGs are understood to have met this week to discuss options to establish a “single commissioning voice”.

A letter sent to local GPs last week said CCG leaders agreed on the need to create “one single commissioning function across Birmingham and Solihull”, although it was ambiguous about the form this would take.

Hunt offers Confed delegates little help with finances

Health secretary Jeremy Hunt had little to offer delegates at the NHS Confederation conference on Thursday in terms of new policy or interventions to help the service tackle its burgeoning problems.

He told managers he was aware people were worried about the deficits in their own organisations, saying: “The question some people ask is if resources are tight should I focus on quality and safety, should I focus on access targets or should I focus on tackling my deficits?”

On the EU referendum debate the health secretary, who is campaigning to remain, said: “Any suggestion the NHS would receive a dividend from leaving the EU is utterly bogus.” He warned of a “Brexit hangover” for the NHS, with damage to the economy meaning potential cuts to NHS spending.

In contrast, the following day Simon Stevens hinted at big policy changes to come. The NHS England chief executive said on Friday the government is planning a major intervention next month to call on NHS organisations to improve their finances. He said the purdah period before the EU referendum constrained what he could say, “but I’m sending as clear a Bat signal as I can that this is going to be heading all our ways sooner rather than later”. He also suggested there is a “strong argument” to prioritise any extra funding towards social care rather than NHS.

NHS Improvement accused of ‘dismantling’ NICE staffing guidance

NHS Improvement has been accused of “undermining and dismantling” official safe staffing guidance after HSJ learned it is revisiting work already completed by the National Institute for Health and Care Excellence.

Senior sources close to the work at the regulator told HSJ it is planning to publish safe staffing guidance for acute inpatient wards and maternity services – despite a pledge by NHS England’s chief nursing officer last year that this would not happen.

One senior source close to the work said: “The goal is no longer to think about safe staffing but safe and sustainable staffing, in other words only what can be done within budget, as if that is acceptable.”

Flawed funding system could be posing risk for babies

On Wednesday HSJ revealed that babies might be “dying unnecessarily” because of a flawed system for funding specialist units.

Fetal medicine was supposed to be commissioned nationally by NHS England. However, in 2014 NHS England revealed that the money for the service was actually tied up in the maternity tariff – specialist units were expected to bill district general hospitals for any referrals they received.

The problem with this is because of the highly specialised nature of fetal medicine services, the cost of a referral frequently far outweighs the money which DGHs get through the tariff.

NHS England has said it is doing work to see whether it could “unbundle” the funding for fetal medicine tariff, with a view to potentially providing more appropriate reimbursement for services in 2018-19.

Minister calls for end to public-private sector divisions

Health minister George Freeman has called for an end to the “apartheid” between the public and private sectors in the funding and provision of health and care services.

He said in a speech on Tuesday: “In my party, we have to end the apartheid that suggests the private sector does all the innovation and entrepreneurship and the public sector just treats people… The NHS is the great engine of innovation that can drive that partnership.”

Giving the political sensitivity around any suggestion, justified or erroneous, of the NHS, or any part of it, being privatised, a government minister’s decision to set out such an agenda in such stark language is significant.

Developers buy up £250m of land from trusts

NHS trusts in England sold land worth more than £250m to developers, housing associations and private individuals last year. Data released by the Health and Social Care Information Centre shows land declared surplus was also sold to charities and local authorities in 2015-16.

Nearly a fifth of the £250m total came from one sale in east London – Barts Health Trust sold 1.6 hectares of land at the London Chest Hospital to a housing association for £49.6m.

As HSJ reported in February, a review of how the NHS can get better value from the land it owns in London is currently being led by UCLH chief executive Sir Robert Naylor. His initial report is due out later this year.

Meanwhile, at the Confed conference on Thursday, Jim Mackey unveiled plans to build 22,000 homes for NHS workers on NHS property.