Essential insight into England’s biggest health economy.

Central London Community Healthcare Trust has been quietly turning into a significant player in the capital.

Having taken over health visiting, sexual health and community adult services in Wandsworth from St George’s University Hospitals Foundation Trust, it now provides services from one end of London to the other, from Barnet to Merton.

The organisation, created from the Transforming Community Services programme of 2011, won the Barnet contract back in the Lansley era and has continued to expand its portfolio from its historic base of Westminster, Kensington and Chelsea, and Hammersmith and Fulham.

The loss of the £37m contract by St George’s could look like a blow to the trust but might instead signal a refocusing of priorities in Blackshaw Road.

The trust traded under the name St George’s Healthcare Trust before it became (highly dubiously) a foundation trust.

Could the dropping of “Healthcare” from the title and replacement with “University Hospitals” reflect the fact that the FT was now focusing on specialist work and giving up the idea of becoming some kind of local exemplar in vertical integration? Croydon and Epsom and St Helier are making the more significant progress on that front anyway.

The other standalone community health organisation in London, Hounslow and Richmond Healthcare Trust, plus the social enterprises covering Kingston and Bromley boroughs, have not been as expansive as Central London, though they have survived, which some thought unlikely in 2011.

When the organisations were created there was concern they might be too small to prosper and could founder in a post Health and Social Care Act world in which each and every low hanging, low capital investment community service line was tendered out and gobbled up by outsourcers.

Perhaps there were never the margins in community care that were hoped/feared.

If outsourcers are disappointed that community services didn’t turn into quite the bonanza many expected, they can still take heart that part of CLCH’s success over the past two years has coincided with Capita taking over a large slug of their back office functions.

Central London’s chief is Andrew Ridley, who set up the relatively successful North East London Commissioning Support Unit, so the trust’s commercial approach to back office shouldn’t be surprising.

The trust now has a turnover of £202m, not including the Wandsworth work, but its problems in recruitment and retention, particularly in the inner London boroughs and for clinical staff, tell a story of considerably more difficulty in providing these services.

Backlog maintenance

Even huge trusts like Imperial feel the loss of 20 beds these days, and that wasn’t the only problem caused by serious estates failures there over the summer.

The trust has calculated some of the damage caused by ceiling collapses and floods on parts of its sprawling estate over the summer.

Following the collapse in Thistlethwayte ward’s ceiling in May the trust will be 20 beds down until the start of 2018. The ward is part of the 147 year old Cambridge Wing.

Floods in June and August saw operations cancelled and the closure of the Paterson Centre surgical innovation unit for 14 days.

A midwife led birth centre in Cambridge Wing has been closed since June, due to reopen in November, and another 10 beds have been lost until “remediation works” are completed in December.

I have already written that Imperial was the trust Sir Robert Naylor alluded to when he said there was an organisation in the capital that was reporting a backlog maintenance figure of £400m whose true total was more like £1.4bn.

London Eye will eat a chunk of decaying masonry if we are mistaken.

The HSJ Strategic Estates Forum is taking place on 20 March at BMA House in London. This is a high-level strategic forum that brings together estates directors, STP estates leads and trust board leaders responsible for the estates function who are developing strategic plans for their organisations and local health economies. The focus of the forum is on issues such as the delivery vehicle for the Naylor Report, the creation of Project Phoenix, advice on establishing SEPs (Strategic Estates Partnerships) and assessing progress of STP estates plans. Sir Robert Naylor, National Adviser, NHS Property and Estates; David Williams, Director General of Finance, Department of Health and Simon Corben, Head of Profession, NHS Improvement are all confirmed as keynote speakers for the event. Register your interest for this free-to-attend event on our website: https://strategicestates.hsj.co.uk/register-your-interest-attending