North by North West: Vanguard cuts for Cheshire and Wirral

Vanguard cuts

Two of the new care model “vanguards” in the North West have seen their transformation funding all but cut off by NHS England in 2016-17.

The Wirral Partners and West Cheshire Way projects received about £5m each in 2015-16, but will receive just £80,000 apiece this year. Both are looking at new care models to achieve better integration of acute and community services.

National leaders said they had to prioritise areas which have made the most progress. Analysis by HSJ suggested a clear choice had been made to back acute care collaboration, also known as “hospital chains”, over other sorts of vanguards.

There’s not been an official explanation for this, but a judgement has perhaps been taken that chains will be able to realise savings on a larger scale (I heard 20 per cent mentioned recently), and more quickly, than other models.

It’s perhaps surprising then that the acute care collaboration for women’s and children’s services in Cheshire and Merseyside has also seen its funding slashed, from £800,000 to £200,000.

I’ll find out where the funding cuts leave the Cheshire and Wirral initiatives. Interestingly, the acute foundation trusts on those patches, Wirral Teaching Hospitals and the Countess of Chester Hospital, are now looking at “horizontal integration” (ie chain type arrangements) across a wider range of services, including ophthalmology, maxillo-facial surgery, ear, nose and throat, back office services and estates.

East Lancashire escapes the shadow of Keogh

I feel like I have a bit of an interest here, as I’ve been a close observer of the ups and downs at East Lancashire Hospitals Trust over the last few years.

When I joined the local newspaper in Blackburn in early 2013, the trust had all sorts of performance and leadership issues, while the board came across as ultra-cagey and defensive.

A Keogh investigation, special measures regime, and two chief executives later, and both the Royal Blackburn and Burnley General hospitals have been rated “good” by the Care Quality Commission.

This means the trust’s overall “requires improvement” rating is likely to be reassessed in the coming weeks, which would make it two out of the original 11 special measures trusts to be led to a good rating by chief executive Kevin McGee (he was previously at George Eliot Hospital Trust).

Of course, former interim chief executive Jim Birrell also deserves credit for leading the initial turnaround, not to mention the rest of the staff.

Meanwhile, the trust’s finance director Jonathan Wood has been seconded to Leeds Teaching Hospitals Trust, to cover the sickness absence of Tony Whitfield. Michelle Brown will act up as finance director at East Lancashire.

Best and worst in the North West

Last week HSJ finished collecting trusts’ outturn financial performance figures for 2015-16, and published some regional tables showing the best and worst performers.

The fact that North Cumbria University Hospitals and University Hospitals of Morecambe Bay had the two largest deficits in the north of England again outlined the seemingly impossible financial challenge facing Cumbria.

It’s not yet clear whether UHMB actually received the £20m or so it was promised through a “local price modification”, but this may be part of the reason for the dire outturn figure.

The numbers are pretty impressive for Liverpool and Bolton, so well done to them.