Make sure you are up to date with the events of the last seven days with our insight into the stories that matter most

Possible indefinite strike by junior doctors

A leak to HSJ from an insider at the British Medical Association has revealed the internal discussion between senior members of the junior doctors’ committee around whether the union should call for an indefinite strike among trainee medics.

The proposal was one of several options by committee chair Johann Malawana that may be considered by the committee at its next meeting. The email discussion following Dr Malawana’s suggestions show that some members of the executive committee have no intention of negotiating with the government over Saturday pay or accepting the contract.

An indefinite strike from 8 June has not been ruled out – and could well be the next step doctors feel forced to take in order to halt the government’s imposition.

Disparity in the financial health of STP footprints revealed

Each of the 44 new health systems are drawing up their “sustainability and transformation plans”, which must be submitted to NHS England by June.

Analysis by HSJ reveals wide disparity in the financial health of the newly created STP footprints with a combined deficit among the clinical commissioning groups and trusts on the patch of around 13 per cent of turnover.

Dr Neil Modha recently announced he would be standing down as chief clinical officer of Cambridgeshire and Peterborough CCG to “rebalance and refocus my work and family commitments”. 

St George’s chief executive leaves

One of the big talking points on on Friday was the departure of Miles Scott as chief executive of St George’s University Hospitals in south London.

His leaving follows intense regulatory scrutiny of the foundation trust’s sudden financial collapse last year, shortly after it got foundation trust status. He will take up a secondment at NHS Improvement.

Paula Vasco-Knight, who has been working as interim chief operating officer at St George’s, has taken the role and last held a chief executive role at South Devon Healthcare FT. She resigned in 2014 after being accused of nepotism in the employment tribunal of two whistleblowers.

CCG awards special contract to GPs

Tower Hamlets Clinical Commissioning Group has awarded an interesting contract for its community services to a company owned jointly by the borough’s GPs.

The CCG had two legal risks: it had to re-tender the contract to protect itself from legal challenge by providers aggrieved at being frozen out, and it had to mitigate a potential conflict of interest arising from GPs occupying both provider and commissioner roles.

So GPs, as members of the CCG, have outsourced their commissioning functions to interims, in order to let a contract which delegates the responsibility for integrating community services to themselves – in the form of a borough-wide provider company.

Merger trust third to be rated “outstanding”

Praise and congratulations have been pouring in for Western Sussex Hospitals Foundation Trust on becoming only the third acute trust to be rated “outstanding” by the Care Quality Commission.

What makes the rating noteworthy is that the trust was formed in 2009 from a merger, which have not always been synonymous with outstanding results in the NHS.

In an exclusive interview with HSJ, trust chief executive Marianne Griffiths revealed the secrets of the trust’s success. Its Patient First initiative was taken on by staff at all levels, who made suggestions and carried out improvements in care – “You have to take hearts and minds with you,” she said.

Gripes over GP vision

Thursday was a big day for GPs, with NHS England’s long-awaited support package-cum-roadmap finally dropping.

The biggest headline was that NHS England said spending on general practice will increase by 14 per cent in real terms by 2020-21, with investment rising “from £9.6bn a year in 2015-16 to over £12bn a year by 2020-21”.

HSJ senior bureau chief Dave West points out: “Reforming primary care requires winning GPs’ hearts and minds, and the General Practice Forward View carefully avoids including material which might stoke the profession’s substantial anger and suspicion.”

But he also argues it is a flawed package.

CQC budget cuts continue

The Care Quality Commission’s budget has been reduced by £9m more than it was expecting this year.

The regulator’s budget for 2016-17 is due to be £236m, and is £13m lower than last year’s.The new figures appeared in the regulator’s draft business plan for the coming year on Wednesday.

Chief executive David Behan said the lower budget was achievable because the CQC was likely to have ended 2015-16 having spent £12m less than planned.

Prioritise investments in special treatments

NHS England launched a consultation on a set of proposals for how it should prioritise investment in new specialised treatments.

Last summer the national commissioner ran a consultation on the “principles” which would inform its prioritisation. In fact, the process has been dragging on since 2014, when the threat of a legal challenge forced NHS England to drop its proposed solution – a “scorecard” – and go back to the drawing board.

It also plays into the pressure on NHS England’s specialised commissioning budget. The commissioner is taking a number of steps to contain cost pressures linked to the arrival of expensive new drugs, such as rationing access to The National Institute of Health and Care Excellence-approved hepatitis C drugs.