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

Kernow’s troubles continue

There are a number of organisations in the South West beset with difficulties, financial and otherwise. But Kernow Clinical Commissioning Group, along with Southern Health Foundation Trust, probably ranks among the most troubled.

The CCG’s problems first came to light in December when it revealed that it was not – as it had previously reported – forecasting half a million pound surplus, but a £14m deficit for 2015-16.

The shortfall ended up even worse than that – according to the latest information from the CCG, it finished with a £17.4m deficit (it actually overspent by £21.4m but was able to improve its position slightly because of a £4m surplus the previous year).

Things will get worse before they get better – the CCG is targeting a cumulative deficit of £38.8m this year in its financial recovery plan, but this will require an eyewatering £41.5m of savings. If it fails to make the savings it could end up with a cumulative deficit of £57m – that would put it in basically the same league as its neighbour Northern, Eastern and Western Devon CCG, which has the largest cumulative deficit in the country.

Meanwhile, Kernow’s chief officer, Joy Youart has been suspended for a number of months while an investigation takes place. The reasons for the investigation have not been explained and the CCG has stressed it does not imply any wrongdoing.

Kernow’s finances resulted in it being placed in “legal directions” by NHS England, which allows the national commissioner to compel a CCG to do various things.

One of the things Kernow was required to do was to commission a “capability and capacity review”. The findings of the review, which were published last week, have delivered a further blow to the organisation – a litany of problems were discovered at the CCG, from “an overall failure of governance” to “evidence of a culture of bullying and harassment”.

The findings chime with local criticism I’ve heard about the CCG. For example, the review said a focus on the CCG’s “future vision” had contributed to “lack of grip on operational performance and finance”. Sources had previously told me they felt the organisation was spending too much time concentrating on ’innovative’ programmes such as its Living Well integration project and Cornish devolution, and not enough time on what should have been its “bread and butter”.

For Kernow’s staff, there is at least a crumb of comfort. According to the review, the new executive team has already made some improvements and shown “an increased level of openness and willingness to challenge”.

The CCG was accused in the capability and capacity review of keeping staff in the dark about the deteriorating finances and pushing items into the confidential section of its governing body meetings to escape scrutiny.

As is so often in the NHS, transparency and a willingness to face up to difficult issues will be the necessary first steps if Kernow wants to properly address its financial and operational challenges.

Bristol children’s services and dementia

In case you missed it last week, an NHS consortium is the only bidder which has been taken through to the next stage of a procurement for children’s community service in Bristol, South Gloucestershire and North Somerset.

While we’re on the subject of Bristol, it has recently been brought to my attention that there’s an innovative dementia service in the city, which has successfully shifted principal management of the condition from secondary to primary care.

Bristol CCG’s dementia wellbeing service allows people to self-refer, with a network of dementia practitioners and navigators across the city providing named support to every GP practice and care home. Combined with a programme of GP education, the service has increased the dementia diagnosis rate from 44 per cent in 2011 to 70 per cent in December 2015.

Well done to Bristol. If you’ve got examples of people doing good, interesting work in the South West, then do get in touch to let me know.

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