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

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Turnaround at Southmead

Since opening in 2014, North Bristol Trust’s Southmead Hospital has had a slightly troubled existence.

Teething problems at the private finance initiative funded hospital, which cost £430m to build, led to poor performance against the accident and emergency waiting time standard.

An inspection report by the Care Quality Commission published in February 2015 described “significant issues with the flow of patients” and rated emergency services at Southmead as inadequate.

What a difference a year makes. In an inspection report published last week the CQC upgraded the A&E department’s rating from inadequate to good.

Patients arriving at the department are now being assessed in a timely fashion. According to figures from the NHS national trauma audit and research network, Southmead had the best survival rate of any trauma centre in England and Wales in 2015.

Sir Mike Richards, the chief inspector of hospitals, said that having been “seriously concerned” at the safety of the A&E in 2015, he was “encouraged” by the new findings and “impressed” by the development of the executive team. The trust is consequently now ranked as good on being well led.

North Bristol has more work to do – as a whole it is still rated as “requires improvement” and the latest CQC report highlights that while there has been a trust wide focus on patient flow within the hospital, more progress is needed.

Still, credit where it’s due: the staff and management at North Bristol deserve a hearty pat on the back for the improvements in patient care they have driven at Southmead.

New year, new contracts

1 April was the start of the new financial year, and marked the beginning of new NHS contracts across the country.

In the South West, a whole batch of interesting and potentially innovative contracts went live, and I thought it would be worthwhile to highlight a few of them.

In Bristol, a consortium of Avon and Wiltshire Mental Health Partnership, Sirona Care and Health CIC, and Bristol Community Health CIC took over as interim provider of children’s community services in Bristol and South Gloucestershire. The previous provider, North Bristol Trust, declined to extend its contract because it wanted to focus its “energies and resources” on “acute and hospital based care” – to evident good effect, as we have seen.

The consortium will be responsible for the services for one year, to give the clinical commissioning groups time to recommission the service on a long term basis.

Will the providers be able to prove to commissioners that they are the right people for the long term contract? If not they, and more importantly the staff, will have to go through the hassle (and for the providers, the expense) of transferring employment contracts for the second time in a year.

Virgin Care had thrown its hat into the ring for the interim Bristol contract – much to the ire of local “anti-privatisation” protestors, buts its bid was unsuccessful.

However it had more luck in neighbouring Wiltshire, where the company’s contract to run children’s community services has also just gone live.

The services were previously provided by five different organisations, so commissioners hope that giving them to a single provider will iron out variation.

Virgin Care is establishing an extensive footprint in the South West – the five year £64m Wiltshire contract adds to the company’s existing children’s services contract in Devon.

In Cornwall, a consortium of NHS organisations has just taken over adult community services.

After the demise of the financially unsustainable Peninsula Community Health, the services have been transferred to a consortium of Cornwall Partnership Foundation Trust, Royal Cornwall Hospitals Trust and the GP federation Kernow Health.

As with the Bristol children’s contract, the Cornwall consortium will be making the argument that giving it long term responsibility for the services offers the best chance of joining up services between providers. The contract is for two years, so it only has a short time to prove that premise.

Are there any interesting new contracts which I’ve missed? I’d be delighted to hear about them: will.hazell@emap.com

Deep South

Deep South is HSJ’s new 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