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.

Bold ambition for mental health

The mental health workforce strategy has finally been published – seven months later than planned.

It sets a bold ambition to create 21,000 new posts across the sector by 2020-21, more than double prime minister Theresa May’s pledge of 10,000 new staff.

But it also admits there are a number of challenges and that the new posts will not eliminate the 20,000 existing vacancies in the sector.

The key figures are 19,000 and 17,000 – the predicted net increase in headcount and total number of expected vacancies by 2020-21 respectively.

These have been arrived at through a series of complex calculations based on a lot of estimates and assumptions and the strategy even admits that if one area performs badly another must perform better to make up for it.

This makes implementing the plan a moveable feast, which the centre has made the responsibility of sustainability and transformation plans, with each STP having to draw up mental health workforce plans, which will include creating the new posts and appointing a senior leader to deliver them.

Debt mountain

The headline financial position of the provider sector may have improved dramatically last year (once the non-recurring sustainability and transformation funding was factored in), but the amount of emergency bailout cash now being paid out to trusts paints a different picture.

NHS trusts were forced to draw down £2.7bn of “interim revenue support” from the government last year – with two-thirds of hospital providers now relying on these government loans to maintain payments to staff and suppliers. The payments totalled £2bn in 2015-16 when around half of hospital trusts received support.

The figures reflect the fact that an increasing number of trusts are struggling to maintain adequate cash levels due to their recurring income and expenditure deficits. In some cases this has led to external suppliers refusing to provide services due to late payments.

They also provide a stark reminder that despite official figures suggesting an improvement to the overall finances of the NHS, much of the trust sector is still in severe financial distress.

When asked about the prospects of repayment, most organisations have a stab at setting out their recovery plan. But the response from Wye Valley Trust was perhaps the most accurate.

Merger milestone

Perhaps the biggest organisational change taking place in Greater Manchester has now been formally approved by regulators.

The Competition and Markets Authority has cleared the planned merger of Central Manchester University Hospitals Foundation Trust and University Hospital of South Manchester FT, saying it would bring “substantial benefits” for patients that will outweigh any damage caused by a loss of competition.

The trusts have already formed an interim board and hope to complete the transaction by October.

STP lead steps down

One of the council chiefs leading an STP is to stand down and hand the role to a local NHS service leader.

Norfolk and Waveney STP executive lead Wendy Thomson, who is managing director of Norfolk county council, said it was “the right time to hand the role on to an NHS colleague”.

Ms Thomson will remain a member of the STP executive board and stay as lead until her successor has been appointed 

Leeds united

The three clinical commissioning groups in Leeds have agreed to start consulting with their members over a merger to become one of the country’s largest commissioners.

This is the next step in a journey which has seen Leeds West, Leeds North and Leeds South and East CCGs appoint a single chief executive and governing body in common to integrate commissioning decisions across the city.

The CCGs’ joint governing body has agreed to consult with its member practices throughout August on whether to merge the organisations.

If the members agree, the trio will submit an expression of interest in merging to NHS England in September.

Leading by example

The money is finally flowing, and NHS England is starting to put some substance into its latest push for digitalisation across the NHS.

So far £385m has been committed to the “global digital exemplar programme”, and some money has even been paid out to trusts, with more expected by the end of the financial year.

That’s a far cry from the £12bn National Programme for IT, the last such big digital push. But, as the failures of that programme showed, money is not the most important ingredient to ensure digital success.

Instead of a massive national programme managed through slightly less massive local service providers, a collection of high performing trusts – and then health economies – will be expected to lead this new digital charge.

These exemplars will act almost like suppliers to their provider peers. They will be put on a procurement framework and paid for their digital services.

However, questions remain about how this approach will work in practice.

NHS goes back to school

A consortium of Imperial College London, Harvard and Edinburgh universities will run a new academy to improve digital skills across the NHS.

Establishing the £6m NHS Digital Academy was one of the key recommendations of Professor Bob Watcher’s review of NHS IT, with the American “digital doctor” highlighting a lack of digital skills, particularly at a senior level, in the health service.

It will be led by Rachel Dunscombe, digital director at Salford Royal FT – one of the NHS’s “global digital exemplars” and another partner in the academy programme.