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Stevens launches hospital chains 'vanguard'

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NHS England will ‘test new ways’ of sustaining smaller hospitals, including ‘chains’ running acute services, in its latest vanguard programme launched today by Simon Stevens.

  • Simon Stevens launches vanguard programme for smaller acute hospitals
  • He says there will be wider review of urgent and emergency care
  • NHS England chief has been contacted by mayors and councils about devolution of responsibilities


The NHS England chief executive said Monitor, the NHS Trust Development Authority and NHS England would be taking forward the work on hospital chains produced by Sir David Dalton last year.

This will include looking at:

  • how trusts can create buddying arrangements across medical specialties rather than whole organisations;
  • how hospitals can share back office functions; and
  • the increased use of satellite sites.

He cited the eye clinic at Dartford and Gravesham Trust run by Moorfields Eye Hospital Foundation Trust as an example.

Simon Stevens

Simon Stevens said trusts were being ‘ripped off’ by staffing agencies

Mr Stevens, speaking at a King’s Fund conference in London, said: “Rather than automatically assuming that ‘bigger is better’, we want to test new ways of sustaining local NHS hospital services, more sharing of medical expertise across sites, and more efficiency from shared back office administration.”

Organisations have until the end of July to apply for the new vanguard programme.

He also told the conference there had been too much focus on individual institutions. He added that the first stages of a proposed “success regime”, which aims to help struggling areas move towards the new care models in the NHS Five Year Forward View, would be launched in a few weeks.

In a separate strand of work there will be a wider review of urgent and emergency care. Mr Stevens said the current system was too confusing for patients, and changes also needed to be made to the metrics used to measure performance.

He said some areas that were particularly struggling with poor emergency performance would need “tighter guard rails” than others, suggesting a step up in intervention or direction by national bodies.

A current focus on measuring and reducing emergency admissions could be broadened, he suggested, and said a focus on the number of bed days lost to delayed transfers of care could be a more indicative measure of how well a system is performing.

Mr Stevens also said hospitals were being “ripped off” by staffing agencies. Organisations needed to set limits on what they pay for agency staff and to act collectively, he said. NHS England will put forward proposals on this in a “matter of weeks”, he said.

Mr Stevens added that the NHS cannot “buy ourselves another few years of the status quo” and that the proposals in the forward view would tackle the pressures being felt now.

In relation to devolution of NHS responsibility, Mr Stevens said mayors and council leaders across the country had contacted him to discuss a possible devolution programme in their own areas.

He said the Greater Manchester devolution plans were interesting not only because it involved pooling budgets but tackling the fragmentation of the health system.

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