PERFORMANCE: NHS Southampton City has said the rapid structural reforms to the NHS reforms could distract from improving the population’s health, while the area’s health economy risks being unsustainable in the long term.

The risk register for the organisation’s extraordinary board meeting on May 26 shows red ratings on two criteria.

One says: “The scale and pace of the NHS reforms could result in a loss of focus on local long term health benefits.” The risk is is potentially catastrophic, the highest possible level of severity, and given a “likely” rating, the second-highest possible grade.

There are also gaps in possible controls and assurance to mitigate the risk, as the GP consortia development plan is not yet ready and primary care trust cluster arrangements still need finalising.

There is a risk of loss of income, unacceptable quality of care, and “national media coverage”, the document says.

Meanwhile all contracts, “particularly those under a payment by results regime” are continuing to overperform.

The risk register says: “Local health moves to foundation trust status and the continuing high levels of admissions to Southampton University Hospitals NHS Trust are affecting the system’s ability to achieve long-term sustainability”.

The objective faces a “likely”, “catastrophic” risk, with gaps in the the control regime in place.

There is a “lack of pace of delivery of demand management schemes, transformation under the quality, innovation, productivity and prevention [agenda].”

However, some action has been taken, including the rebasing of contracts for 2011/12, a major review of financial arrangements at Southampton University Hospitals.