Trust chief speaks out over commissioning 'disaster'

Peter Homa has also said the trust’s dermatology department, which in 2013 had 11 consultants, will be left with one full-time and one part-time consultant from July.

Dermatology services were transferred to the Circle-run Nottingham Treatment centre in 2013 following a competitive tender by Rushcliffe CCG that split emergency and elective and adult and children’s services between the trust and Circle.

In a statement following the publication of an independent review into the transfer, Mr Homa said the changes imposed by commissioners “dismantled Nottingham’s previously distinguished dermatology service, including research and teaching to trainees and medical students”.

“This situation was consistently raised and predicted by NUH consultants. Many of our most experienced consultants have left NUH to work at other centres. From July this year we will have one full-time and one part-time consultant,” he added.

A draft of the independent review, revealed by HSJ last month, said the process followed by the CCG and providers was an “unmitigated disaster”.

Mr Homa said the decision to split the services meant that the trust could no longer integrate the different elements, as the number of consultants leaving had left “our paediatric and emergency services were increasingly stretched”.

He added: “Our attempt to set up a limited elective service for local adult patients which would have allowed us to retain more of our consultants was halted by commissioners last year on contractual grounds. This further limited our ability to retain and recruit consultant dermatologists to NUH. By February 2015, we were left with no option but to scale back our adult emergency service.”

Mr Homa said the trust’s immediate priority was to recruit an additional consultant to maintain its paediatric service.

The report, published by Rushcliffe CCG, “highlights many lessons from which the NHS can learn”, Mr Homa said.

He added: “Our interpretation of the report’s main finding is that a new model of delivery is required to achieve a sustainable and affordable dermatology service in the future. It is clear that without a more radical approach to commissioning and employment contracts that this is unachievable and will not recreate a service that NHS consultants wish to join.”