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HSJ Catch Up

This weekly email gives HSJ subscribers a vital update on the biggest stories 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.

One of the key planks of the 2012 Lansley reforms was to give clinical commissioning groups greater power to select different providers for services, whether public or private.

But a recent procurement process in the North West demonstrates that while that might still be the law, it often no longer works like that in practice.

Halton CCG had named One Primary Care – part of One Medical Group – as its preferred bidder to run two urgent treatment centres, following a recent tender process.

But the CCG was then threatened with a legal challenge from at least one of the incumbent NHS providers, and received a grumpy letter from GPs that had been involved in designing the £25m contract (and who were part of the NHS-led bid).

Charter seeks safety and fairness

The NHS does not have the best reputation when it comes to dealing with patient safety incidents and balancing the needs of both the patient and staff affected.

Time and time again stories have emerged of patients and their families not getting the answers they are entitled to under the NHS’s duty of candour, while – in some cases – staff have been unfairly thrown under the bus.

But now a new charter and additional guidance has been launched by the national body in charge of managing the costs of claims made against the NHS for clinical negligence.

NHS Resolution, formerly the NHS Litigation Authority, has drawn up the “Being Fair” charter in a bid to ensure trusts respond appropriately when a safety breach occurs.

The organisation hopes the charter could be a trigger for boards to change that.

Turning the tables

Not that long ago, Sir David Nicholson was sending missives to troubled NHS organisations, ordering them to get their house in order.

Now, the former NHS England chief executive (and national and regional chief) chairs a troubled hospital trust which is on the receiving end of such missives and which, under Sir David, has rejected its latest marching orders from the centre.

Worcestershire Hospitals Acute Trust is one of just four in England to have declined to agree to a control total – essentially a financial plan – with NHS England/Improvement for 2019-20.

The centre told the trust to hit a £64.4m deficit. The trust responded earlier this year by saying the most it could commit to was an £82.2m deficit. The trust has since shifted to £73m, but this is still well short of the saving the centre insists can be achieved.

In the dark

Frustration is growing among NHS procurement professionals about the lack of detail on savings expected from a new centralised purchasing model.

From April, trusts have had portions of tariff income withheld by NHS England. These amounts have been used to fund the operating costs of NHS Supply Chain, which has been reorganised in a bid to deliver savings for the NHS.

But NHS Supply Chain have recently told trusts a “system issue” was preventing the organisation from working out accurate savings forecasts.

In a nutshell, this means trusts are paying for a service with little idea of what they are getting in return. This makes it harder for local procurement chiefs to deliver much-needed savings within their own organisation, and NHS Supply Chain has acknowledged the “challenging conversations” these unfortunate souls will now likely face with their finance teams.

National concern?

Cambridgeshire and Peterborough Clinical Commissioning Group’s decision to push back the discussion of hugely controversial proposals to axe NHS-funded IVF just hours after HSJ reported the recommendations raises fundamental questions over who is really in charge of commissioning local services.

It said it needed to save £32.7m to hit its target of achieving a £75m deficit in 2019-20 – a huge deterioration from the £35m deficit it recorded last year.

But, just hours after HSJ reported the controversial recommendation was set to be put before the board, the CCG issued us with a new statement.

It said: “The CCG has today [1 July] received new information from the Department of Health and Social Care about the commissioning of IVF services. Because of this the CCG has decided to review this information with NHS England and bring the decision back to the CCG governing body on 6 August.” 

Pinching pennies

Finance teams hoping for some loosened purse strings for buildings and maintenance spending during 2019-20 may want to steer clear of their mail. NHS England and Improvement have sent a letter asking trusts to cut their combined capital spending plans by a fifth.

The regulators pleaded with trusts to scale back their grand plans in May, as capital spending plans exceeded the limit set by the Department of Health and Social Care by some margin.

This appeal, however, only persuaded providers to slice 3 per cent off of their combined spending proposals. So, the national bodies have now told providers to work on a system basis (within their sustainability and transformation partnership or integrated care system) to prioritise spending..

Not-so-great expectations

In stark contrast to his digitally-enthused boss, Matt Hancock, NHSX chief executive Matthew Gould has used his first salvos in the job to lower expectations on NHS IT investment.

Mr Gould, who officially started in the role as effective NHS tech tsar on Monday, told HSJ last Thursday that getting a sceptical Treasury to part with more money for NHS IT would be a big job.

Earlier that day, he told an audience at a tech conference in London he was nervous about overpromising NHS IT improvement.

When HSJ asked about the latest target to digitise NHS trusts by 2024, which was set less than six months ago in the long-term plan, Mr Gould said it was “doable” but a “stretch”.

A name but no go-ahead

The project to merge three Essex acute trusts and create a new £850m beast now has a name: the “Mid and South Essex University Hospitals Group”.

The branding will likely stay whatever its future statutory form – but when will the formal merger happen?

The three trusts originally planned to merge this April but the move was recently pushed back to April 2020. The delay was partly caused by their clinical reorganisation, which has sparked some controversy and was referred to the health and social care secretary by local councils.