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

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Welcome to North by North West

This is the second edition of HSJ’s new email briefing on the 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: lawrence.dunhill@emap.com. If someone forwarded this to you, sign up to get your own copy here. In future you will need to be an HSJ subscriber to get it. Subscribe here.

Devolution on a leash

Amid the fanfare of ‘Devo Manc’, which officially launched last week, there were a couple of reminders that NHS England will remain heavily involved in the region for some time yet.

We already knew the Greater Manchester chief officer would be an employee of the national body, and the identity of the chosen candidate suggests a strong influence from London.

Reading between the lines, it sounds as though a Whitehall big hitter was deemed necessary for the job, and Department of Health official Jon Rouse fitted the bill.

The announcement surprised a few people locally, who felt Ian Williamson, who has held the role on an interim basis, was the favourite. He will now return to Central Manchester Clinical Commissioning Group.

Although the choice grates a bit against the spirit of devolution – which is of course supposed to be about Greater Manchester taking charge of its own affairs – it’s perhaps unsurprising given the scale of local ambition, and nervousness from the national bodies.

The threat of A&E delays

One of Mr Rouse’s primary concerns will be performance in the provider sector, which needs to improve if “synthetic devolution” is going to develop into real devolution.

The obvious one is accident and emergency, as the region has some of the worst performers in the country against the four-hour standard.

Unless performance improves, devolution will barely have got off the ground before it’s subject to “intervention” by NHS England.

There are of course multiple reasons why Greater Manchester is struggling on this standard, but there is a real danger that media and political scrutiny could focus on devolution as a cause, rather than solution to the problems.

Inquest continues into Liverpool trust failings

Over in Merseyside, the fallout from serious governance and care failings at Liverpool Community Health Trust looks set to continue. HSJ has learned that complaints against Helen Lockett, the trust’s former director of operations and executive nurse, are being investigated by the Nursing and Midwifery Council. The regulator was due to convene an interim order hearing yesterday.

External investigators have compared some practices at the trust to those at the now dissolved Mid Staffordshire Foundation Trust, and even Sir Mike Richards - not a man of easy soundbites - said that was “probably a fair comparison”.

HSJ has tried to reach the Liverpool trust’s former chief executive, Bernie Cuthel, who stepped down in 2014, to hear her side of the story. Perhaps unsurprisingly, we’ve not heard back from her current employer, the Betsi Cadwaladr University Health Board in North Wales

GP deal under scrutiny

Meanwhile, MPs in Liverpool have been criticising a £27m deal for private company SSP Health to run 20 GP practices, after a number of complaints were received and four of the surgeries were rated inadequate.

The Liverpool Echo reports that 15 of the contracts will not be renewed, while five will stay with the firm for another year while new operators are found.