Weekly updates and essential insight into the NHS in the South West, by Will Hazell

A new ‘challenged health economy’?

Last week was the long awaited “reset” – a desperate attempt by system leaders to try to “bend the curve” of the NHS’s worrying financial and waiting time performance.

In the blizzard of initiatives announced by NHS England and NHS Improvement it was easy to lose track of exactly what was going on, so I’ve tried to condense what the reset means for the South West.

The poor picture painted of the commissioning system was perhaps the most disturbing thing to emerge for the region.

Five CCGs were judged to be inadequate under NHS England’s new rating system, and as HSJ’s handy map shows, there are no splashes of outstanding green in the region.

NHS England’s assessment carries consequences, with a new intervention regime of “financial special measures” also unveiled last Thursday.

South Gloucestershire and North Somerset CCGs – both rated inadequate – have been placed in the regime. The groups have been directed to work with neighbouring Bristol CCG “to move towards a single commissioning leadership structure across the STP footprint”, though it is currently unclear exactly what this will look like.

On the provider side, North Bristol Trust has been placed in the trusts’ version of financial special measures.

North Bristol experienced the biggest deterioration in its finances in the final months of 2015-16, and was put in the new regime because it is planning a significant deficit of £48m and has not agreed a “control total” for this year.

Elsewhere in the South West, Dorset County Hospital Foundation Trust, Dorset Healthcare University FT, Plymouth Hospitals Trust and Poole Hospital FT all have the sword of Damocles hanging over them. If they don’t reach a deal on their control totals, they could also end up in special measures.

It’s not yet clear what special measures will mean for North Bristol, but the centre has some potentially painful instruments in its locker. NHS Improvement could take control of key spending decisions and change the trust’s leadership, while the Department of Health could make future bailouts contingent on signing over ownership of “surplus assets”.

With two CCGs and one trust in financial special measures, the Bristol, North Somerset and South Gloucestershire STP patch appears to have joined the unenviable list of “challenged health economies”.

New boss for Royal Devon

Royal Devon and Exeter Foundation Trust has announced who will be taking over from Angela Pedder as permanent chief executive.

Julia Hartley-Jones, a former chief nurse at Oxford University Hospitals FT, will take up the role in January.

Ms Hartley-Jones has spent the last decade working in a variety of health management roles in Australia, so she will add to the region’s stock of antipodean health experience.

Ms Pedder left the trust in late June after nearly 20 years at the helm to become “lead chief executive” of the Devon success regime.

Suzanne Tracey, one of the trust’s deputy chief executives, has been appointed acting chief executive until Ms Harley-Jones’ arrival.

Deep South

Deep South is HSJ’s email briefing on the NHS in the South West of England.

It takes an in-depth weekly look at a region which is one of the NHS’s most innovative, but also one of its most turbulent. The patch includes the cities of Bristol and Bath, through Wessex and Dorset, and all the way down the peninsular to Lizard Point.

Please get in touch with any suggestions about what you’d like to see covered and any story tips: will.hazell@emap.com