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Relationship between NHS Trust and CCG

Below is a letter from the Chief Executive of the NHS Trust Development Authority about the relationship between Northern Devon Healthcare Trust and NEW Devon CCG.

11 December 2014


Rt Hon Ben Bradshaw MP House of Commons London SW1A OAA


Dear Ben,

Relationship between Northern Devon Healthcare NHS Trust and North, East and West Devon Clinical Commissioning Group


Please accept my apologies for the delay in responding to your letter. The relationship between Northern Devon Healthcare NHS Trust and North, East and West Devon Clinical Commissioning Group has been strained over the last two years. In 2013, arbitration was required to agree the 2013/14 contract and both parties needed mediation to address in-year issues. The need for formal dispute resolution is often a symptom of deeper issues with local relationships.


As you will be aware the financial and operational pressures facing the NHS in Devon are very significant. Earlier this year 11 health economies around the country were identified as being challenged in terms of financial stability and sustainability. Devon was one of the systems identified. When faced with challenges of this order it is difficult to overstate the importance of partner organisations working together professionally and constructively. This is clearly not the nature of some of the relationships in Devon and this needs to change as a matter of urgency.


There is of course a role for national organisations, including the TDA, to play their part in supporting and facilitating systems through some of the challenges they face and through some of the difficult discussions which will inevitably be involved. This being the case we have played an active role, along with NHS England, in the work that has been initiated locally. This is ongoing and it is important from my perspective that this level of engagement is maintained and increased during the weeks and months ahead.


Contract negotiations carry a particular risk to relationships and I cannot overstate the importance of commissioners and providers holding fast to the fundamental challenge of achieving the best outcome for patients, local services and the NHS throughout those discussions. With this in mind we supported the appointment of a facilitator to support contract negotiations for the current year. The facilitator was an experienced previous Primary Care Trust Chief Executive and he supported both parties to reach an agreement.  We will be similarly involved, if not more so, in the next annual planning round that will commence early in the New Year.

Northern Devon Healthcare NHS Trust is delivering against the majority of performance standards and has recovery plans in place which are on target to address those areas where performance is currently falling short.  These include deliverables on cancer and stroke.  However, I am very clear that the right kind of working relationships are critical to achieving sustainable performance.  This must be a priority for NHS leaders in Devon as it is for me and the TDA.

I would, of course, be very happy to discuss any aspect of the issues that exist in Devon at any stage.

Yours sincerely,

David Flory

Chief Executive NHS Trust Development Authority

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