North by North West: Taking a risk on community care

Backing Bridgewater

If the NHS was operating with a more generous (and arguably more appropriate) funding envelope, then Liverpool’s troubled community services would be near the front of the queue for extra investment.

In a scandal that has been likened to the care and governance failings at Mid Staffs, Liverpool Community Health Trust hacked back on frontline staff while pursuing its foundation trust ambitions prior to 2014 – leaving the workforce depleted and demoralised.

It is now in the process of being split up, with Bridgewater Community Healthcare FT named the preferred provider for the main element of the services after agreeing it could deliver the contract on £77m of recurrent annual funding.

The deal has brought heavy criticism of Liverpool CCG, which only agreed to chuck in £4.6m of extra non-recurrent funding after concerns were raised by the interim leadership at LCH. Concerns remain over the impact on the services when this non-recurrent funding expires.

Rival bidder Mersey Care FT was of the view that once the £4.6m was withdrawn, it would be impossible to deliver the services safely. Bridgewater appears to disagree, so let’s hope the trust is proved right.

There does appear to be weight in the arguments put forward by the CCG and Bridgewater – essentially around the significant opportunities for efficiency savings through the takeover and joint working with social and primary care.

But given the recent history of these services, relying on such savings feels like a risk when they are still in the process of rebuilding.

It comes back to the funding envelope, because it’s not as if the CCG is awash with spare cash, or that it’s been bunging it all into the acute sector.

As I’ve previously reported, it’s actually managed to reach an agreement which will limit spending on acute care next year to 1 per cent above this year’s baseline.

There could be some room for manoeuvre down the line, so if it’s felt the non-recurrent funding should be extended beyond 2018-19, the CCG could reassess. It will be worth keeping an eye on this.

CQC verdict

Meanwhile, we are still awaiting Bridgewater’s inspection report from the Care Quality Commission, following a full visit in May last year.

Anything less than a good rating, which was what was achieved by Mersey Care, and it’s going to look suspiciously as though quality has been trumped by finance in awarding the services discussed above. West Lancashire MP Rosie Cooper, who helped expose the problems at LCH, will be more than ready to start making this point as loudly as she can.

Social care demands

Sir David Dalton has joined Jon Rouse in calling for an urgent increase in social care funding, warning that patient care will otherwise be “compromised”.

These are two men held in high regard in Whitehall, and certainly not known for tub thumping. The government will surely have to give in on this one, but will be looking for ways to do it without losing face.

More control

Leaders in Greater Manchester are seeking control over their share of the £1.8bn sustainability and transformation fund. This is currently paid out by NHS regulators with agreement from the Treasury, depending on whether individual organisations hit their financial targets.

A decision on this could depend on GM’s financial performance this year, with the case bolstered if the region can better the national average.

PVK trial

Paula Vasco-Knight is facing a jail sentence after pleading guilty to fraudulently paying her husband more than £11,000 while in charge of South Devon Foundation Trust.

Ms Vasco-Knight, who is from Runcorn in Cheshire, had previously pleaded not guilty to fraud at Exeter Crown Court, but changed her plea last week.

She was charged with the offences in May last year, but had previously resigned from the South Devon trust in May 2014, after being suspended in the wake of an employment tribunal judgement which criticised the trust’s handling of two whistleblowers.

She went on to do interim work for East Lancashire Hospitals Trust between July 2014 and July 2015, before a short stint as acting chief executive of St George’s University Hospitals FT last year.

She will be sentenced alongside her husband on 10 March.