Nuffield foundation bid back on

Nuffield Orthopaedic Centre trust has been given the green light to submit a foundation application following a rethink on its likely income.

HSJ understands Nuffield had been held back from applying to the independent regulator by the Department of Health because officials needed more information about its long-term financial stability.

The trust has long waiting times and according to the national reference cost data published this month, it is a high-cost provider - 22 per cent above the national average.

Part of this results from the inadequacies of the healthcare resource groups used to calculate costs and their failure to reflect accurately the true costs of the trust's specialist activity.

But a trust source told HSJ: 'We realised we had been pretty conservative in our predictions [of our likely income] when we saw what some of the other [foundation candidate] trusts had done - some of the assumptions they were making - and so we went over our figures again.

The department is satisfied and has said it would be fine-tuning the HRGs to make them work better.'

Trust chief executive Ed Macalister-Smith, who said he was 'absolutely delighted' his trust had been given the go-ahead to apply, told HSJ there had also been discussions with primary care trusts on commissioning arrangements, 'to ensure we are clear about what's going to be happening'.

Health secretary John Reid revealed last week that Nuffield would join the other 24 trusts whose foundation status application is being assessed by independent regulator Bill Moyes.

But in November, Oxford City PCT chief executive Andrea Young wrote to Mr MacalisterSmith expressing strong reservations about the impact foundation status would have on the local health economy.

She said: 'This development cuts across the PCT's role in commissioning locally responsive services. The tie into three-year [legally] binding contracts limits PCT flexibility to make changes, balance priorities and implement [patient] choice. Under foundation trust status, it may be more difficult to commission change to clinical pathways.'

She added: 'Oxford City PCT is yet to be convinced of the benefits of foundation status.'

Although her letter was sent more than two months ago, it is still unclear whether these concerns have now been resolved. On Monday, a spokesperson said Ms Young was on leave and therefore the PCT was unable to comment.

Nuffield has also been targeted by anti-foundation trust campaigners who are now threatening to stand for election to the trust's board of governors should it win foundation status. The Oxford Campaign Against Foundation Hospitals is led by Mark Ladbrooke, chair of Unison's Oxfordshire health branch.

'[Nationally] Unison has met on this issue and I think it was decided that local people, local activists, will have to make decisions themselves - something that we will discuss.

'What we have learnt already is that, despite all the talk about mutualism and local democracy, the consultations so far have been a joke. This is being forced on us without any real input from the people it effects.'