HSJ Catch Up: Trusts on track with financial plans, and Stafford faces new challenges

Trusts almost on track with financial plans

As HSJ foretold last week, the first official performance report for the NHS provider sector has suggested that trusts are broadly on track with their financial plans for 2016-17.

The overall NHS provider sector has reported a deficit of £461m for the first three months of the financial year, which was £5m better than planned.

Frustratingly, NHS Improvement only published a supplementary report on Thursday, along with a press release hailing the good news.

Though not completely clear, the report seems to suggest that the current year-end forecast for the sector is £644m, which would be £64m worse than the planned £580m. And don’t forget, this includes the entire £1.8bn sustainability fund. It says further action will be taken to avoid this.

• The deficit train has slowed – but it is still moving

Deadlines for STP leaders confirmed

Summer is over, and a painfully ambitious two year, whole system, early planning round is here.

Letters sent to sustainability and transformation plan leaders in recent days confirm that operational plans and contracts for the 24 months from April 2017 will be expected to be pinned down by the end of December.

That may come as something of an unwelcome shock to those who are still spending their time rowing over 2015-16 activity and contracts. The timetable is well meant – the aim being to get planning and petty disputes out the way in order to get on with implementing the change outlined in STPs.

The recent updates to the system give a few signals on the context, too, ahead of planning guidance due on 20 September.

Data sharing platform revealed

A new data service capable of recreating key elements of the controversial Care.data project is being developed by the National Information Board and could receive Treasury approval as early as next month, HSJ exclusively revealed on Wednesday.

The new “data services platform” will comprise IT infrastructure and software applications that will “collect, store, process and analyse patient level data” from health and social care providers, including primary care, according to a document seen by HSJ.

It is intended that the platform will feed into a “customer facing data access and analytics service”. This would make data available to customers with “legitimate requests” and would comply with “emerging national data standards for secondary use data” – a reference to the recommendations in the recent Caldicott report.

While the platform is not designed as a direct replacement for Care.data, a senior source warned “it could easily become that. The danger is that in doing so it could fall into exactly the same sort of problems that Care.data did”.

The Care.data programme became mired in controversy over how patient identifiable data would be collected and used, and was criticised for lack of clarity. It was put out of its misery in July, after costing £7.7m.

Raised eyebrows over Bath contract

Last week Virgin Care was announced as preferred bidder for a seven year contract to deliver community services in Bath and north east Somerset.

The company beat a consortium led by Sirona Care and Health that included two NHS providers – Avon and Wiltshire Mental Health Partnership Trust and Royal United Hospitals Bath Foundation Trust.

Bath and North East Somerset Clinical Commissioning Group and Bath and North East Somerset Council want to bring the disparate services together under a “prime provider” to join up services and stop patients from having to go from pillar to post for their care.

HSJ asked Jane Shayler, the council’s director of adult care and health commissioning, whether this “surplus” referred to anything left over from the “margin” that Virgin Care – a profit making organisation – would usually be expected to make on such a contract.

“No [it means] any surplus… ‘margin’ to my mind is just another way of describing a surplus,” she replied.

Nevertheless HSJ readers appeared to remain unconvinced.

• Private provider beats trusts and GP federation to community contract

New concerns at Stafford

You may have been forgiven for thinking that the Stafford hospital problem had been fixed. Sadly the hospital (renamed County Hospital), infamous for the care scandal and subsequent public inquiry that followed, is back in the headlines.

University Hospitals of North Midlands Trust, which took over the former Mid Staffordshire FT, has announced a temporary suspension of services for children at the hopsital’s A&E because of fears the department is not safe.

In particular the trust is worried that a shortage of staff trained in specialist skills for paediatrics, including life support resuscitation and anaesthetics, means it cannot safely treat children. The department sees an average of 30 children a day.

CSU redundancy bill revealed

The bill for redundancies following the closing down of two commissioning support units earlier this year reached more than £6m, HSJ revealed on Tuesday.

A total of 142 people were given severance deals from Yorkshire and Humber CSU and North West CSU, which were closed in March.

North West CSU, which served CCGs in Cheshire, Merseyside and Greater Manchester, and Yorkshire and Humber CSU had been unsuccessful in their bids gain accreditation to join NHS England’s lead provider framework. NHS England said the changes will save money on back office support and improve support services.

Figures from NHS England show £6.2m was spent on payouts, with the costs borne by clinical commissioning groups and NHS England. The national body was “unable to confirm” the amount of redundancy costs that fell on CCGs when asked by HSJ.

Oxfordshire CCG goes again

Some HSJ readers may remember the difficulties Oxfordshire has had developing new forms of contracting for integrated care. These stretch back to 2013, when an attempt to let three big outcomes based contracts collapsed.

We have learned that Oxfordshire CCG, which has an unforeseen deficit and rising demand, is now having another go. The commissioner is knocking heads together after its two main providers failed to integrate care on their own – the contract could involve most community services, urgent care and primary care.

The CCG doesn’t mention new care models overtly, but the multispecialty community provider policy framework is the most useful lens to view this through: as per that document, the CCG has stated a preference for any bids to involve the local GP federations.

Inevitably we’re reminded of another infamous integrated contract, which collapsed because there wasn’t enough money in the contract to make it work. Hopefully Oxfordshire’s approach to setting up the deal will avoid the elementary traps Cambridgeshire fell into.

Four trusts given power to lead

NHS Improvement has given four high performing acute trusts the power to lead groups or chains of hospitals, effectively giving them the green light to begin setting up partnerships, federations or even mergers and acquisitions.

In the quartet, Northumbria Healthcare and Salford Royal have both been rated outstanding by the CQC, while Guy’s and St Thomas’ and the Royal Free London are rated good.

Plans are still being hammered out, but include sharing clinical standards, back office corporate services and the creation of a standard operating model, which each trust joining a group will have to adopt.