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Five chief executives run two trusts each

Five NHS hospital chief executives now run more than one trust, with HSJ revealing on Tuesday that Ipswich Hospital Trust’s Nick Hulme is taking the reins at troubled neighbour Colchester Hospital University Foundation Trust. 

Mr Hulme joins an elite band of NHS managers running more than one trust. The others are:

Uncertain future for Southern Health

Troubled Southern Health Foundation Trust has received a significant amount of regulatory oversight and intervention since the publication of a report in December which revealed the trust had not properly investigated and learned from the deaths of service users.

A highly critical Care Quality Commission inspection report followed, and an extra condition was added to the trust’s licence empowering NHS Improvement to make “management changes” if progress was not forthcoming. The trust’s chair was replaced shortly afterwards.

However, intervention from the centre could ratchet up even further – on Monday HSJ revealed that the trust could be broken up.

Cambridgeshire trusts edge closer to merger

Peterborough and Stamford Hospitals Foundation Trust and Hinchingbrooke Health Care Trust edged a step closer to merging on Wednesday.

The two Cambridgeshire trusts will consider and outline business case for merging by April 2017 at their board meetings.

As exclusively revealed by HSJ in March, this is a plan which has been heavily pushed by Monitor, now NHS Improvement.

But is this sensible?

Certainly, the status quo is not an option for Hinchingbrooke. It has one of the largest deficits as a proportion of turnover in England, a £17.1m deficit on revenues of £112m for 2015-16, rendering it financially unsustainable. Lord Carter’s team identified it as the second most financially inefficient trust in the country.

But heading down the merger at pace route outlined in the business plan will almost certainly take the trusts on a bumpy journey.

NHS Improvement reshuffle

NHS Improvement has begun consultation with its employees on a major restructure of the staff it inherited from Monitor and the NHS Trust Development Authority.

The proposed changes would see the number of full-time equivalent posts in NHS Improvement fall to 1,113, down from 1,244 last year.

However, staff have been told that NHSI has reduced recruitment and filled roles with temps in recent months, meaning the current permanent staff number is around 100 full-time equivalents fewer than under the proposed new structure. As a result, HSJ understands that the new regulator expects only a small number of redundancies.

In some teams, current staff numbers are the same or fewer than are proposed in the consultation. However, the new roles available may require different skills to the current posts. NHSI proposes to fill the new roles through “slotting in”, for example where there is only one contender, and “ringfenced” competition.

Official: NHS provider deficit – and the breakdown in your region

Figures published by NHS Improvement showed the provider sector ended 2015-16 with a deficit of £2.45bn. This was £460m worse than the revised in-year plan, and £650m worse than the £1.8bn “control total” set by regulators last year.

But the figure wasn’t quite as grim as those reported locally by NHS trusts would lead you to. As revealed in analysis the day before, these figures suggested the sector deficit was closer to £2.7bn. It is not yet clear why there was a discrepancy, though papers published by NHSI refer to other “one-off technical measures” taken between December and March, which may not have been reported locally. Some trusts also didn’t include the benefit of capital to revenue transfers in their year-end board papers.

The cost of the junior doctors’ contract dispute

Following yet another leak to senior correspondent Shaun Lintern, HSJ reported that the British Medical Association council was warned in mid-March that the junior doctors’ contract dispute had cost it almost £3m – and the level of spending was not sustainable in the long term.

BMA treasurer Andrew Dearden informed council members the union had by then spent £2.9m fighting the dispute with the government. This figure is likely to have increased considerably following the full walkout by doctors in April and preparation for legal action.

Meanwhile, NHS Improvement stated at its Friday board meeting that the 10 days of industrial action had cost the NHS provider sector £65m in lost in activity.

GPs consider industrial action

With an agreement being reached with junior doctors earlier in the week, the government may have hoped it wouldn’t have to worry about industrial action for a few days at least. Not so.

At the local medical committees conference on Friday, GP representatives have voted unanimously to ballot the profession on potential industrial action, and the possibility of signing undated resignations. They backed the motion in response to what it said was an “inadequate” response to the sector’s problems in NHS England’s General Practice Forward View. LMC chief executive Michelle Drage said the GPFV was “not a rescue package… at best it’s a distraction”.