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.
Trusts could ‘bank’ land sale money
There is some comfort for NHS leaders in the government’s response to the Naylor review on NHS estates.
The Department for Health and Social Care has backed the idea of sustainability and transformation partnerships keeping land sale receipts.
Foundation trusts could always keep this cash (as long as they weren’t in special measures) but the privilege is now to be extended to humble NHS trusts too. But this freedom will only be with the approval of the STP.
The arguing over whether, for example, a trust would want to sell land to pay for the refurbishment of someone else’s GP surgery is yet to be had – though that’s what STPs/ACOs are there for.
The arguments will be overseen by the arm’s length Strategic Estates Partnership and the non-arm’s length NHS Property Board.
The latter will be chaired by health minister Lord O’Shaughnessy and it remains to be seen whether its firm retention by the DHSC – in opposition to Sir Robert’s recommendation – will make it more or less “powerful” than the former UCLH chief executive intended.
Sir Robert acknowledges in an HSJ interview that the sums at stake might warrant the board being held close to Whitehall, but implicitly questions whether the DHSC has the capacity to manage multiple multimillion pound schemes.
Still counting the cost of NPfIT
The National Programme for IT was “dismantled” more than six years ago but will likely cost the NHS millions for years to come.
On 3 October 2017, the DHSC quietly paid multinational tech company Fujitsu £65.2m.
This was more than the DH paid any NHS trust that month, and was eclipsed only by payments to NHS England and other central health bodies.
It is considerably more than the NHS expects to spend on rolling out Wi-Fi this financial year.
However, the payment was not made for services rendered by Fujitsu, at least not recently, but as part of a legal dispute that started during the collapse of NPfIT nearly a decade ago.
The dispute has not been closed and further payments in the tens of millions of pounds are entirely possible.
This is not the only bill the department is still footing years after the programme was ditched, nor the only failure of a programme once labelled “the worst and most expensive contracting fiasco” in public sector history.
But as the NHS attempts another, albeit far more modest, programme to improve trusts’ IT systems, it serves as a costly reminder not to repeat the mistakes of the past.
CAMHS beds boost
NHS England has confirmed that more than 130 new child and adolescent mental health beds have been commissioned as part of national plans to expand capacity by 10 per cent by 2019.
While many of the beds were marked for London, the South and South West, some will be opened in Yorkshire and Humber and the Midlands as well.
The new beds represent the bulk of the expansion announced by NHS England in March last year, which it will fund as part of the Next Steps for the Five Year Forward View.
When completed, the promised increase by 150-180 beds will be one of the largest expansions of CAMHS in the last 10 years, increasing the existing 1,440 bed base by more than 10 per cent.
Trusts challenge Virgin contract decision
A public health contract for school nursing and health visiting services was set to be awarded by Lancashire County Council to Virgin Care. The company reportedly won the contract by the “narrowest of margins” ahead of a joint bid by Lancashire Care Trust and Blackpool Teaching Hospitals Foundation Trust.
The trusts, which are the incumbent providers of the services on their patches, said their bid was in keeping with the ethos and aspiration of the area’s STP.
While the services in question are quite small, the council’s decision has notable consequences.
A contract award to Virgin would mean the trusts collectively missing out on £20m a year, and (if you believe local campaigners) would lead to a further fragmentation of health services in the county.
However, Virgin has already picked up another contract in West Lancashire for urgent care and community services so it is not an entirely new player in the health economy.
There is more to come in this story, as the trusts have challenged the council’s procurement, which has forced it to delay awarding the contract to Virgin.
The incident adds fuel to the argument that proper integration in the NHS can only be achieved with new legislation that addresses the competition and procurement issues that come with the internal market.
Smallest hospital trust to merge
The smallest acute trust in England is due to merge with its neighbour, after years of struggling with unsustainable services.
University Hospitals Bristol FT confirmed on Wednesday its intention to merge with its smaller neighbour, Weston Area Health Trust, which also supports the move.
Automatic stop to incremental pay structure
A new contract for medical consultants in the NHS will scrap the “all but automatic” incremental pay structure and replace it with a significantly higher base salary, the DHSC has said.
In its evidence to the Review Body on Doctors’ and Dentists’ Remuneration, the government also revealed plans to make substantial reforms to clinical excellence awards. It said these would be replaced with locally driven, time limited, non-pensionable payments more closely linked to the objectives of NHS trusts.
The proposals said consultants will lose their right to opt-out of non-emergency work at weekends but no current consultant will have their salary reduced under the reforms.