Your essential update on health for the week.

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.

Consolidation continues

A mental health trust is preparing to seek a merger or acquisition by another provider in a bid to address its financial challenges.

In a message to its staff, the North West Boroughs Healthcare Foundation Trust said growing financial pressures were “likely to put the quality and safety of patients at risk”.

Elsewhere the preferred approach is to move to joint leadership instead of – or at least as a precursor – to merger.

In London, there’s been a veritable wave of trusts holding hands: it was announced on Thursday that the new chair of Epsom and St Helier University Hospitals Trust will be Gillian Norton, who will continue to chair St George’s University Hospitals FT.

The move marks the second largest pair of organisations to have a single chair, after the announcement earlier this year that the chair of Guy’s and St Thomas’ FT would also run the board of neighbouring King’s College Hospital FT.

Publish or be…

The government belatedly published its “Yellowhammer” no-deal Brexit preparation summary on Wednesday night. Yet NHS chiefs point out that even this is now more than a month old, and they really should have up-to-date predictions and plans to work with.

In Yellowhammer as elsewhere, the impact of no-deal Brexit on social care services – with its reliance on a low wage, mobile and often European workforce – is increasingly a major concern for the health service.

It was mentioned by the NHS’ Brexit lead as one of his two top concerns earlier this month; and Yellowhammer outlines how wage (and other) inflation could send care providers under. Our workforce briefing – by correspondent Annabelle Collins – this week also explores regulatory barriers to overseas nurses.

Skidmore out, Argar in

There’s been yet another shuffle around of ministers at the Department of Health and Social Care. This time, Edward Argar, MP for Charnwood in Leicestershire, has replaced Chris Skidmore as health minister.

Mr Skidmore’s tenure in the role has been brief, having only arrived shortly after Boris Johnson’s move into number 10 in July. Mr Argar will be the fourth person to take on the role since the department added “and Social Care” to its title in January 2018.

Second time lucky

Doctors and nurses could be allowed to set their own level of pension contributions each year, as part of the government’s latest bid to tackle the pension crisis gripping the NHS’ workforce.

The measures form part of the government’s second attempt to consult on what flexibilities could be offered to clinicians who are finding themselves caught out by pension tax rules. It comes amid reports of staff refusing to take on extra work, reducing hours or retiring early in efforts to stop themselves being landed with a hefty tax bill.

This is the second time government has attempted to consult on the issue this year. In initial proposals under Theresa May, now dropped, a 50:50 option was put forward, which would allow clinicians to halve their pension contributions in exchange for halving the rate of pension growth. The 50:50 model was criticised as being “not fit-for-purpose” and “a paycut” which was “bound to fail”

Getting closer

North east London could soon have a joint chief executive and chair running Barking, Havering and Redbridge University Hospitals Trust and North East London FT, in part of regional director Sir David Sloman’s drive to reduce the potential and actual barriers to integration across the capital.

The move follows a review commissioned by joint chair Joe Fielder and authored by Sir David Dalton, who led the creation of the Northern Care Alliance in Manchester.

Life is just too short

The role of an NHS trust chief executive has never been easy. Even when money was flowing, there were still incredible demands to reduce waiting times and deliver on projects like private finance initiative and foundation trust status.

You go to sleep at night (if you can manage to sleep) aware that any one of your 5,000 plus staff could do something that will land you and your organisation on the front pages or in court.

Add to that the endless financial challenge that is NHS senior management these days and it’s not hard to see why South Tees chief executive Siobhan McArdle has decided enough is enough.

In a stark farewell email to trust staff, Ms McArdle delivered a withering assessment of the environment she was working in – an unsustainable health economy with challenging regulators and no realistic prospect of a plan out of the quagmire.