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

Trusts to merge

The future of Bedford Hospital Trust has long been in question after the hospital said in 2012 that it wasn’t sustainable as a standalone organisation.

But it was widely believed that whatever the future of Bedford would be, it would involve Milton Keynes University Hospital Foundation Trust.

However, HSJ exclusively revealed on Tuesday that, contrary to expectations, the hospital is instead “exploring” a merger with Luton and Dunstable University Hospital FT.

What this all means for the fledging accountable care system in the region is still unknown.

A takeover was not mentioned in NHS England’s announcements about ACS regions in March or June.

The chief executive of Bedford, Stephen Mr Conroy said the merger proposal is “not replacing” the ACS.

Company sues NHS England

Without wishing to pre-judge the result of a court case, the background to the clinical waste market in the NHS is interesting.

SRCL, which is pursuing NHS England over what it says are £2.5m in unpaid bills, is one of several players in that sector.

Providers in that market say their margins have been pared right back by e-procurements, reverse auctions and a commissioner approach that puts cost saving over everything else.

SRCL, owned by US giant Stericycle, complains that this risks a return to the days of potentially dangerous clinical waste being dumped inappropriately, if the NHS commissions bargain basement suppliers.

Southern Health’s new boss

Southern Health FT has named Nick Broughton as its new chief executive. The current chief executive of Somerset Partnership FT will start his new job in November.

The announcement comes shortly after HSJ revealed Southern Health is considering divesting itself of its community services provision, which accounts for a third of its £321m income.

First ever STP merger

HSJ broke the news on Wednesday that health leaders in the North East are in discussions over merging three sustainability and transformation partnerships to create the largest in the country.

Northumberland, Tyne and Wear and North Durham STP, Durham, Darlington, Teesside, Hambleton, Richmondshire and Whitby STP and West, North and East Cumbria STP already have a number of shared work programmes.

Winter flu warning

Freeing up delayed transfer of care beds will be vital to ensuring the NHS has enough beds to manage winter pressures and a possible flu outbreak, says Simon Stevens.

Mr Stevens told Expo 2017 this week that the priority for the next 3-5 months was to ensure that the NHS was as strong as possible to deal with winter pressures.

He said Australia and New Zealand had suffered from a major outbreak of flu, which resulted in hospitals closing their doors to new patients and long waiting lists.

The NHS England chief’s comments were echoed by his director of operations and information Matthew Swindells.

This is the clearest sign yet that NHS leaders are worried about the coming winter, with NHS Improvement chief executive Jim Mackey warning urgent action was needed to ensure enough hospital beds are available over winter.

Mr Stevens said a lot of work will need to be done over the next 6-8 weeks to prepare for the expected pressure.

This includes reducing delayed discharges to free up 2,000-3,000 beds, but there are fears that reducing DTOCs by 50 per cent or more is “undeliverable”.

Pathology networks

Times are changing fast in the world of NHS pathology.

The sector, which plays a part in 70 per cent of all diagnoses to NHS patients, faces a centralisation programme from NHS Improvement as part of the regulator’s drive to make Carter recommended efficiencies.

In essence, the plan is to create 29 pathology networks across England, in which one or two trusts will provide the most high volume and complex cases while the others carry on with routine work.

But (and it is a big but) what will trusts, consultants and the lab workers make of this?

Some trusts will be forced to scale back their pathology services while their neighbour expands, which is likely to be a bitter pill for some to swallow.

North West expert Lawrence Dunhill predicts unhappiness from East Lancashire Hospitals Trust at the prospect of services being moved to Lancashire Teaching Hospitals Foundation Trust.

It also remains to be seen if the Competition and Markets Authority – which has previously examined NHS pathology joint ventures – takes an interest, a scenario raised by competition expert Andrew Taylor.

Meanwhile, the response from the Royal College of Pathologists was mixed – with praise for NHSI’s data collection but doubts over the project’s timescale and savings target.

DH ‘exit packages’ jump

The Department of Health and its executive agencies spent £39m on “exit packages” last year, following the departure of more than 700 staff.

The bulk of the leavers in 2016-17 related to a major restructuring and cost cutting programme at the DH.

In a parliamentary answer published this week, health minister Philip Dunne said “voluntary exits” of DH staff accounted for £31m of the expenditure.

HSJ revealed the DH’s restructuring plans in January, which followed a redrawing of the NHS funding ringfence in the 2015 spending review to exclude the department and other central bodies. More than 500 staff took voluntary redundancy.

Weeks later it emerged that around 200 new staff would be recruited to ensure the “right skill mix” within the department, which was partly in response to the challenges posed by the Brexit negotiations.