HSJ’s daily digest of Friday’s significant developments for healthcare leaders

NHS England’s plan to trial a number of “viable small hospitals” has stalled for the second time.

The trusts which had submitted successful expressions of interest for the pilot, which is a key plank of NHS England’s “vanguard” project, were supposed to be informed when NHS England unveiled its main vanguard cohort in March. This was delayed and trusts were told a new request for proposals would be made at the end of last month.

However this didn’t happen, and HSJ understands the request will not be sent out before late May (when there may be more certainty about who will form the next government). Don’t expect any announcement on which small hospitals have been picked until June at the earliest.

This leaves one of the more controversial elements of provider reform outlined in the NHS Five Year Forward View expected to get under way a month or so following the general election. Assuming it has the support of new ministers, that is, presumably.

Monitor has beefed up its performance improvement capabilities.

The foundation trust regulator announced today that it had appointed someone to lead its new “provider sustainability” division.

Adam Sewell-Jones, who was deputy chief executive of Basildon and Thurrock University Hospitals Foundation Trust, will head up the new directorate, tasked with supporting trusts to tackle operational problems and leading Monitor’s work on implementing new care models.

In a possible sign of the directorate’s new role, Monitor’s 2015-16 business plan highlighted “a mismatch” between its regulatory role and the pressure it’s under to directly performance manage struggling providers.

To borrow a phrase from Monitor’s chief executive David Bennett in an interview with HSJ last year, the regulator’s “arm’s length” has been getting “a little shorter”. And it may need in turn to take a closer grip of the provider sector.

Mr Sewell-Jones should know something about turning round underperforming trusts – he was at Basildon when it emerged from special measures.

Sticking with Monitor, the regulator announced today that it was probing St George’s University Hospitals Foundation Trust’s finances.

The trust delivered a £16.8m deficit in 2014-15.

In these financially straitened times, so far so unremarkable. However Monitor only approved St George’s as a foundation trust in February, and did so on the basis that it was supposedly going to end the year by breaking even.

Did Monitor, other national officials, or St George’s know about the trust’s rocky finances before its authorisation was approved? If they didn’t, then why not?