Essential insight into England’s biggest health economy, by Ben Clover.

The election campaign is upon us and all over the NHS people are bound by the rules of public sector neutrality during the “purdah” period, until at least 13 December.

So it’s not clear whether some big announcements will in fact get made before Christmas.

For example, the £2.25bn, 15-year pathology contract for a broad swathe of south London.

The three bidders (HSL, IPP and Viapath) were expected to make their best and final offers this Friday.

“BAFO” is the crucial stage before the announcement of the preferred bidder where the contenders make their revised offer to the buying consortium - having already been given a provisional ranking.

This commercial deal will have a significant effect on the shape of health services in the region long after most of the people taking the decisions have moved on.

The contenders themselves are interesting. HSL is the north London collaboration between Royal Free London FT, University College London Hospital FT and Australian firm TDL.

IPP is a subsidiary of European firm Synlab, and operates NHS services in Essex and the West Country.

Viapath is the incumbent provider and is co-owned by Serco plus King’s College Hospital FT and Guy’s and St Thomas’ FT - the two NHS organisations also being among the eventual customers of whichever bid wins.

You would expect a process like this to be conducted carefully, and papers published by the south east London integrated care system show some of the steps which have been taken.

A paper presented to the board of the area’s ICS in August on the process noted that legal firm DAC Beachcroft had been hired ”to provide legal advice to ensure robust moderation process, in preparation for evaluation panel on September 2 to consolidate workstream evaluation scores, confirm bidder ranking, and agree recommendations to programme board”.

(BTW, the bid team have never confirmed who is actually on the programme board, only the organisations represented - this isn’t really very transparent considering we’re talking about two-and-a-quarter-billion pounds of taxpayer money).

The ICS paper added the team had “sought QC advice on any legal risks to a potential down-selection decision”.

It would be interesting to know what “legal risks” had been considered.

The tender notice said the procurement would be conducted under the ”light touch regime”, allowed by public contracts law of 2015.

It said: ”The contracting authorities intend to follow a procedure which broadly follows the process of a competitive dialogue, but will not be bound to follow all of the prescriptive elements of that procedure.”


London contains the only two trusts to have switched out of their local pathology network, according to the most recent NHSI analysis. Lewisham and Greenwich Trust in south east London is, as we have previously reported, joining the east London network.

While more recently, suburban giant London North West University Hospitals Trust has left the north west London network to go in with north central London.

This latter move goes against the idea that gradually a Chelsea & Westminster Hospital-led group would come to manage the whole of NWL - taking in Imperial College Healthcare Trust and LNWUH.

The latter are advertising for a new chief executive when Dame Jacqueline Docherty retires in the Spring, and the ad doesn’t suggest you’d end up as a hospital director in some kind of group/chain model (unlike over in Barking, which starts interviewing for another interim next week).

Goodbye Professor Goldstone

Staying north of the river, another two chairs at big trusts have taken on chairing at smaller trusts.

UCLH’s Baroness Julia Neuberger will now also be in charge of nearby Whittington Healthcare Trust.

Perhaps less expected was Royal Free’s Dominic Dodd taking over at the Royal National Orthopaedic Hosptal Trust.

The regional director’s office eventually confirmed incumbent RNOH chair Professor Anthony Goldstone had retired in August, 13 months before his term was due to end.

He’d been there eight-and-a-half years and people retire but what was notable about it was the local MP saying that two other non-exec directors whose terms were not renewed had been “dismissed by NHS London”.

The regional director’s press office said: ”Both NEDs were informed that their terms would not be extended alongside the appointment of the new chair, as per the NHS England/Improvement appointments process.”

So it feels like there was maybe some disagreement.

There were two interesting nuggets from the May board meeting minutes, approved at Professor Goldstone’s last public board meeting in July.

The UCL fellow reported that ”despite recent issues with UCL, research remained important to the trust, associations with other universities were being explored and it was anticipated that a first introductory meeting with Brunel university would take place within the month”.

The minutes also noted the trust “would not bid to become a local elective centre” as part of the north London adult elective orthopaedic review.

The minutes noted it would instead work towards ”becoming a specialist centre for orthopaedics for north London and beyond” - which it kind of already is.