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

Kernow departure

The health service’s leadership troubles are well reported.

We’re familiar with the headlines: high turnover of senior managers, excessive reliance on interims, and a dearth of suitable applicants for the top roles.

Some of these problems have been captured in microcosm in the South West in recent weeks.

First, there was the departure of Joy Youart as managing director of Kernow Clinical Commissioning Group – eight months after her suspension was first announced to clear the way for investigations into the organisation’s structure, running and finances.

The CCG was placed under legal directions by NHS England back in December after it emerged that it was heading for a large and unexpected deficit. A review by PwC in May was scathing about the management of the organisation.

According to the CCG’s statement, Ms Youart decided she was “not the right person to take the CCG forward” and “it was time for new challenges”.

The CCG was keen to stress that she would not receive “any additional payment in relation to her departure, other than outstanding contractual payments”. That at least should help the CCG avoid the headlines which have recently dogged Southern Health Foundation Trust.

Trust’s chief executive search resumes

Further up the peninsula, Royal Devon and Exeter Foundation Trust has also had a spot of leadership trouble.

Because of a lack of candidates, South West trusts have had to look beyond their shores for chief executives.

Kathy Byrne was recruited from Australia to lead Royal Cornwall Hospitals Trust, and Royal Devon and Exeter also went down under to find Julie Hartley-Jones to succeed Angela Pedder.

However, last week we learned that Ms Hartley-Jones will be staying in Australia, so it’s back to the drawing board for the trust.

She was due to start at Royal Devon and Exeter in January, but the trust announced she was now “not in a position to return to the UK”.

It followed local criticism of Ms Hartley-Jones appointment, after it emerged the hospital she used to manage in Australia was forecasting an $80m deficit.

Of course, it’s not all doom and gloom for leadership in the South West.

In fact the region is shaping up as a test bed for a completely new style of place-based leadership – Ms Pedder’s decision to leave the provider sector to lead the Devon STP footprint and success regime could be a model that’s adopted around the country.

But Cornwall and Devon are health economies which are not short of problems. Both Kernow CCG and Royal Devon and Exeter FT will want to get strong, permanent leaders in post quickly so they can roll up their sleeves and begin addressing the challenges.

STP round-up

A couple more South West STPs were published last week.

The Somerset STP voguishly proposes the creation of an “accountable care system” by April, made up of a single commissioning function holding a joint health and social care budget, and an “accountable provider organisation”.

Will the latter be a group of bodies with a shared governance structure, or a single entity formed through the merger of Somerset’s trusts?

We don’t know yet, but consolidating acute services across Taunton and Somerset and Yeovil District Hospital FTs is another big STP priority.

Gloucestershire also published its STP, unveiling plans for new models of care based around 30,000 populations, GP surgeries forming 16 “clusters” from 2017-18, and a network of urgent care centres across the county.