West Country Chronicle: Where four out of five CEOs are new

All change

2023-24 was a brutal year for Devon Integrated Care System’s NHS CEOs. Of the five CEOs in post at the start, only one remains as we approach 2024-25. 

Both Royal Devon University Healthcare Foundation Trust and Devon Integrated Care Board have new chiefs in Sam Higginson and Steve Moore respectively, after the departures of Suzanne Tracey and Jane Milligan.

Devon Partnership Trust – the ICS’s mental health provider – is also under new (temporary) leadership with Phill Mantay in charge following long-serving CEO Melanie Walker being off work since autumn 2023. Ms Walker had to undergo a spontaneous coronary artery dissection - a rare heart event which mainly affects women - but is thankfully recovering well and undertaking a phased return to the trust.

The latest change in Devon, announced early last month, saw University Hospitals Plymouth Trust CEO Ann James step down.

Although formally departing at the end of March, Ms James is currently on leave – with finance director Sarah Brampton assuming the role of acting CEO.

Ms James’ departure - following a 12-year stint - came somewhat abruptly and has the whiff of external forces at play.

Particularly notable was the the short length of time between announcement and departure, given the many years of service Ms James has devoted to the trust.

Critics point to its performance against key performance measures; particularly in emergency care, where UHP has routinely been at the bottom of the national table.

However, the trust has – to an extent — been rather let down by bureaucratic process, with millions of pounds promised at the end of the last decade to expand its accident and emergency never having arrived.

Ms James’ departure - and the lack of a return date for Melanie Walker to assume full CEO duties — leaves Liz Davenport (Torbay and South Devon FT) as the only current CEO from Devon’s all-female crop of NHS CEOs in-post going into 2023.

It’s transformation time

Speaking of investment, the leadership changes couldn’t have come at a more important time for the ICS.

It desperately wants to exit the lowest rung of NHS England’s national oversight framework (unlikely given current performance), while having almost £1bn of national infrastructure funding being allocated over the next seven years.

Its three acute trusts are all in the New Hospitals Programme, and two (Torbay and South Devon and UHP) are getting their first trust-wide electronic patient record.

TSDFT has opted for Epic, the same as neighbour RDUH, and UHP is likely to go the same way.

Stable leadership will be critically important to deliver these major infrastructure projects, which represent a one-off opportunity to embed some long-term sustainability into Devon’s hospitals.

But the challenges will be many. Already, UHP’s board has discussed the risks associated with the “near simultaneous implementation” of three EPRs on the peninsula (Royal Cornwall Hospitals Trust has procured Cerner).

The implementation comes at a time when there is a national shortage of skills and expertise to help install EPRs successfully, according to NHSE.

More building delay?

Meanwhile, there are also concerns over the New Hospitals Programme projects.

RDUH has already raised concerns about the delay imposed by government, while TSDFT is warning of a “significant risk” to its timetable unless its outline business case changes - according to board papers.

The nature of the changes needed is not clear, but – given the glacial pace of NHP’s progress – any risk of delay will set hares running in local management circles.

UHP also has NHP problems, in the shape of costs currently being set to out-strip the amount allocated. The trust has had to convene an extraordinary private board meeting to consider an options appraisal for the project.

• Article updated at 12.27pm on 5 March to include more information about Melanie Walker’s absence from Devon Partnership Trust