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 fifth 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

The Calderstones question

Two and a bit years ago, I visited Calderstones Hospital in Lancashire to see the finishing touches put on a shiny new inpatient facility.

I was working for the local newspaper at the time, and was told the £7m building represented a “major new chapter” for Calderstones Partnership Foundation Trust.

As it turns out, that new chapter will involve the new Maplewood 2 unit being closed down, along with the rest of the Whalley site, by 2018. Meanwhile, board papers published last week confirm the FT will be taken over by Mersey Care Trust in July (if as expected, Mersey Care first gains FT status).

I realise now that I should have given the learning disabilities trust a bit more attention in my old job, where my time was always dominated by troubles at the local acute trust (sound familiar?).

But I have to admit to being less informed that I might have been about the impending national policy directions in this long ignored area of the health service.

As Sir Stephen Bubb pointed out in his 2014 review for the government, there have been calls for several decades for patients with autism or similar conditions to be supported in the community, rather than large scale ‘institutions’.

The Winterbourne View scandal, exposed by Panorama in 2011, forced the government the following year to promise imminent change. Progress then stalled until 2015, when NHS England finally set out a timeline for closing Calderstones and other large facilities.

If I neglected to ask the right questions a couple of years ago, what about those who were planning and investing in these services in 2013?

It doesn’t say a great deal about the way our health service is planned, by both local and national leaders, that the brand spanking new Maplewood 2 was being built just as national policies were about to enforce its closure. Let’s hope a bit more thought has gone into the mass discharge of patients, as there could be dire consequences of getting this wrong.

It’s still to be decided what will happen to the facilities at Calderstones, although it would certainly be worth a few quid to housing developers.

Or maybe Lancashire Care Foundation Trust could make use of it? The mental health trust has promised East Lancashire a 70-bed inpatient unit, although seems to have gone quiet on this project of late.

Finding a partner

Efforts to find a “stability partner” to reopen Chorley’s accident and emergency department have come to nothing.

After the staffing shortages led to the sudden downgrade of the unit last month, local commissioners put out the urgent appeal for other providers to step in.

Given that Lancashire Teaching Hospitals Foundation Trust can’t sustain the A&E in the present environment, with all its infrastructure and experience, it’s not surprising that the notice came and went without much interest from others.

A troubling “clique”

A troubling review has found a “clique” of midwives at Wirral University Teaching Hospital Foundation Trust led to other staff feeling ostracised and unable to raise concerns about maternity services.

The leaked report also said senior managers were aware of the clique and had “reinforced” its behaviour rather than challenge it.

The trust’s new nursing director appears to be fronting up to the issues however, sharing a full copy of the cultural review with HSJ and taking “appropriate management” action against individuals identified.