University Hospital Southampton Foundation Trust saw the largest increase in its specialised services income last year, new information obtained by HSJ reveals.

The trust saw its specialised income rise in cash terms by £32.4m to £262.2m in 2014-15.

Southampton General Hospital

University Hospital Southampton’s specialised services income rose to £262m last year

It is now the heavyweight tertiary provider on the south coast, and is likely to be the focus for further centralisation of services in coming years.

A long running process to centralise vascular services in Southampton restarted earlier this year.

According to data released by NHS England under the Freedom of Information Act, the 10 biggest specialised services providers stayed broadly the same in 2014-15 compared to the previous year (see table, below).

Leeds Teaching Hospitals Trust remained the biggest provider, with specialised income of £415m – an increase of 6 per cent on the previous year.

King’s College Hospital FT moved into the top 10 after an 11 per cent increase in its specialised income to £309m, while Imperial College Healthcare Trust dropped out after its income rose by only 0.9 per cent.

The 15 biggest earners from specialised services, 2014-15

Provider Specialised services income (m) % increase on 2013-14
Leeds Teaching Hospitals Trust £415.3 5.7
Guy’s and St Thomas’ NHS FT £383.7 4.9
Oxford University Hospitals FT £356 2.2
University College London Hospitals FT £349.4 4.1
The Newcastle upon Tyne Hospitals FT £342.6 4.6
Central Manchester University Hospitals FT £334.7 5.8
University Hospitals Birmingham FT £327.7 6.7
Barts Health Trust £316.1 4.7
King’s College Hospital FT £308.8 11.2
Sheffield Teaching Hospitals FT £295.9 3.7
Imperial College Healthcare Trust £288 0.9
University Hospital Southampton FT £262.2 14.1
Great Ormond Street Hospital for Children FT £261.4 3.5
Nottingham University Hospitals Trust £254.5 7.7
Cambridge University Hospitals FT £248.7 3.2

The outturn spend for trusts with NHS England specialised services contracts in 2014-15 shows that there has been no attempt to radically centralise services, with a “long tail” of small specialised services providers remaining.

In 2014-15, 24 acute trusts received specialised services income of less than £10m, compared to 23 providers the previous year. The acute trust with the smallest specialised commissioning budget was Hinchingbrooke Health Care Trust, with income of just £3.9m.

The financial clout of the biggest trusts increased relative to the rest of the sector, but only marginally.

In 2014-15 the providers with the 10 biggest specialised budgets accounted for 31 per cent of specialised spending in the acute sector, compared to 30 per cent in 2013-14.

Under previous chief executive Sir David Nicholson, NHS England proposed centralising specialised services into 15-30 centres.

There was a shift in policy when, shortly after taking over as chief executive last year, Simon Stevens said he still saw a role for smaller hospitals delivering these services.   

The largest proportional increase was for Lewisham and Greenwich Trust, where specialised income rose by 56 per cent. This followed the trust acquiring Queen Elizabeth Hospital in Greenwich in October 2013.