HSJ Catchup: Hunt on NHS leadership, funding games and new waiting targets

Hunt’s management talk

At the NHS Providers conference on Wednesday, Jeremy Hunt probably made his biggest policy intervention for more than a year, announcing a package of measures aimed at reshaping the NHS workforce.

New policies were abundant, but the top line was that Mr Hunt wonders whether introducing a general “manager class” for the NHS may have been a “historic mistake”. This was a strange line to take in a speech that also sought to confront the problem of morale in the workforce – but it was no slip of the tongue. Unusually for Mr Hunt, he read his speech from notes rather than memory.

Mr Hunt compared the level of clinical leadership at the highest levels of the service to other systems around the world and noted that the NHS has relatively few chiefs from clinical backgrounds. But confusingly, he also pledged to increase the number of graduate management trainees by a quarter.

The health secretary also announced:

• Health Education England will examine whether doctors will be able to choose clinical leadership as a specialism with a dedicated programme.
• NHS graduate scheme places will be doubled to 200 in 2018, followed by a phased increase of 1,000 places a year.
• A review of professional regulation by Faculty of Medical Leadership and Management to encourage nurses and doctors to move into leadership roles will be completed in 2017.
• The NHS Leadership Academy will send 30 students a year to global universities to fast track their move into senior management.
• The launch of an “NHS MBA” for senior professionals in September.

Funding games

Editor Alastair McLellan has written in this week’s leader column about the consequences of the government and the NHS’s standoff over funding.

He warns: “In this game of financial chicken many in the NHS believe they have time on their side, that a bailout is just one or two scandals away. It is a dangerous assumption.”

• Expert briefing: The chancellor has NHS managers in his sights

Dudley CCG leading the race for MCP milestone

The race to create the first multispecialty community provider has begun and Dudley CCG is currently the leading player.

This week it took the first step in procuring the contract for its MCP with the publication of a prior information notice, and market engagement event will follow in January.

Most interestingly, a document seen by HSJ suggests the provider could hold the budget for adult social care services in Dudley.

New targets for handling mental health crises

NHS trusts will soon have to report how quickly they are treating patients experiencing mental health crises in accident and emergency, and hospitals.

New guidance from NHS England sets out how acute and mental health trust should set up liaison psychiatry teams and meet the new emergency access and waiting time target from April 2017.

Liaison psychiatry is a key part of the Five Year Forward View for Mental Health, with all hospitals having to have a team by 2020-21, with at least 50 per cent of teams working 24/7.

The targets demand that patients in A&E suffering an urgent or emergency mental health crisis should be seen by the liaison psychiatry team within an hour. Emergency patients should then have a care package within four hours, while urgent cases should have one within 24 hours.

Major contract to end early

A large hospital trust is looking to terminate a contract with a private company worth £200m over five years amid concerns relating to poor standards.

A leaked email from Nottingham University Hospitals Trust chief executive Peter Homa, seen by HSJ, confirmed the trust is looking to agree “a managed exit” from the estates and facilities contract with Carillion after months of warnings.

In October, we reported that nurses were cleaning ward areas after Carillion staff had finished their work. There have also been complaints over rats, overflowing bins, a shortage of linen and lack of availability of equipment and portering services.

The trust warned the company in July that unless there were improvements it would terminate the contract and last month the board agreed there had been “insufficient progress”.

Staffs contracts get the go-ahead

After an 11-month pause, a major project to tender £1.2bn worth of cancer and end of life care services in Staffordshire has been given the go-ahead by NHS England.

The decision is a vote of confidence by the national commissioning body for the work of four Staffordshire CCGs working on the programme.

The contracts were paused after the collapse of the Uniting Care contract in Cambridgeshire, which led NHS England to come up with a new regime for assuring major contracts and to kill off the strategic projects team – the NHS’s in-house commercial advisers.

Not so new care model

Stockport Foundation Trust and borough council have tapped into the trend of reviving all things nineties and noughties for running their new care model.

The term “care trust” was introduced in the 2000s under the NHS Plan. Local organisatons were given the power to create care trusts with their local authorities – bringing together the commissioning and provision of health and social care services under one organisation.

The FT, council and other health and social care providers for the Stockport Together vanguard project now want to create a new care trust to run the area’s MCP contract.

Under this option, Stockport FT and the council would create a care trust, which would hold the MCP contract and the contracts for all other health and social care services. However, HSJ understands core primary care services would not be provided by the care trust. Instead the new organisation would subcontract services out to GPs.