Essential insight into NHS matters in the North West of England, with a particular focus on the devolution project in Greater Manchester. By Lawrence Dunhill

Welcome to North by North West

This is the sixth edition of HSJ’s new email briefing on health services in the North West of England.

North by North West will take an in-depth weekly look at one of the NHS’s most challenged and innovative regions. There will be a particular focus on the devolution experiment in Greater Manchester, but my scope will also include Merseyside, Lancashire, Cheshire and Cumbria.

Please get in touch to let me know how I can improve it, and to tip me off about stories you think I should cover: If someone forwarded this to you, sign up to get your own copy here

FT status just the start

The foundation trust pipeline has become pretty clogged up in recent times, but in the past week two Merseyside trusts have managed to squeeze their way through.

Congratulations to Wirral Community Trust and Mersey Care Trust, whose chief executive Joe Rafferty believes the approval process was “one of the toughest that any trust has ever had to go through”.

Given the embarrassment and trouble St George’s University Hospital FT has caused for Monitor (and latterly NHS Improvement) since its authorisation last year, I suspect Mr Rafferty is right.

The Mersey Care authorisation is particularly noteworthy, as it paves the way for the trust to complete its takeover of learning disabilities specialist Calderstones Partnership Foundation Trust in July.

As I wrote last week, the job will then be to discharge patients from Calderstones Hospital and close the East Lancashire site within three years.

So where will the Calderstones residents go?

Well, some are already being discharged into various community care schemes, while those who need to be housed in secure forensic units will wait to be moved to a new facility being built in Maghull.

Then the plan is to provide three separate units, each with 20 low secure and 10 community beds, with one of these in East Lancashire.

With jobs at risk and unions already campaigning to “save” Calderstones, identifying these sites and getting started will be crucial to getting staff onside.

Mersey Care should also ensure it retains the positive practices and leadership already present in the learning disabilities provider. For all its operational struggles and existential questions, we should remember the impressive turnaround Calderstones has achieved in the last year – recognised in its recent “good” rating from the Care Quality Commission.

Do people really get a greater say?

On a side note, NHS Improvement’s press release hailed the authorisations as ensuring “a greater say for local people”. Does anyone really buy this?

Have any FTs really managed to build up an active and effective membership body, which is truly involved in decision making and holding the trust to account? I’m not so sure. But tell me if I’m wrong.

Is David Dalton working too hard?

I’m a bit worried that Sir David Dalton is working too hard. As you read this email, the country’s top chief executive will again be leading the government’s side in negotiations with the British Medical Association over the junior doctors’ contract, after both sides agreed at the weekend to resume talks.

This is clearly a massive task, and it says much about his skills that the BMA has welcomed his continued involvement.

But it’s worth remembering everything else on Sir David’s growing to-do list. He continues to run Salford Royal FT of course, and has recently taken the top job at a second, larger trust (with huge problems) as well. This is Pennine Acute Hospitals, in case you missed it.

If this isn’t quite enough already, an integrated care organisation is about to be launched in Salford (hosted by Salford Royal), while a hospital chain is being formed across the north of Greater Manchester (following his blueprint). These are two massively complex and ambitious projects in their own right.

Sir David knows what he’s doing, and no doubt has some trusted lieutenants to help lead the projects, but he should be careful not to overstretch his considerable talents. Greater Manchester needs him.