Two east London NHS trusts announce restructure plan to recruit joint CEO which health bosses insist ‘is not a merger’

The Barking, Havering and Redbridge University Hospitals Trust (BHRUT) and the North East London Foundation Trust (Nelft) announced on Monday, September 9, that they were together looking to recruit a joint chief executive as part of the NHS Long Term Plan to have the two organisations work much more closely.

Both BHRUT and Nelft are rated Requires Improvement following their most recent Care Quality Commission inspections - Nelft actually saw its rating downgraded from Good earlier this month following inspectors' most recent visit.

But tri-borough health bosses believe the move will help break down barriers between the different local healthcare organisations and help each organisation learn from the better working practices of the other.

This "NHS group model" system has already begun with the creation of a joint rehabilitation ward for stroke patients and the foundation of a community-based rehabilitation team.

In a joint statement from Joe Fielder, who is chairman of both organisations, and Chris Bown and Oliver Shanley, interim chief executives of BHRUT and Nelft respectively, all three insisted "this will not be a merger".

The two trusts will continue to have separate sovereign boards, which will choose which powers to delegate to committees in common, shared between both trusts, which will have their own executive and non-executive directors and be responsible for governance across both organisations.

Acute services and community and mental health services will continue to be operationally managed separately.

The plans came about after Mr Fielder commissioned Sir David Dalton - former chief executive of Salford Royal NHS Trust and an expert in quality improvement and patient experience - to provide his opinion.

The ongoing discussions have also included the impact of the group model changes on Nelft's other services across Waltham Forst, Barnet, Essex and Kent, with Nelft currently anticipating it will continue to provide these services outside of the newly-conjoined BHR health economy.

The statement concluded: "This is the beginning of a very new journey for BHRUT and Nelft.

"None of it will happen overnight and we promise to keep you informed and updated at every stage."

The trusts have also published the full report submitted by Sir David following his review.

In his executive summary, Sir David acknowledges that both trusts "are committed to work in ever closer union" to try and deliver improvements.

Recommendations in the report include the creation of three Local Care Organisations (LCOs), one each for Barking and Dagenham, Havering and Redbridge.

These three LCOs would be responsible for all elements of healthcare in their boroughs, and councils would be encouraged to integrate their social care responsibilities with them.

Each LCO would have a chief officer, and each would be made responsible for a principal site. Havering's chief officer would be in control of Queen's Hospital in Rom Valley Way, Romford; Redbridge's would be based at King George Hospital in Barley Lane, Goodmayes; and Barking and Dagenham's would take up residence at Goodmayes Hospital.

According to the report: "It is likely that some services will be 'hosted' by one LCO on behalf of others where this made operational sense."

In their statement all three directors said: "This proposal is not something that BHRUT and Nelft can, or would want to, introduce on our own.

"It is something that senior leaders across BHR would have to agree to collectively and the future of our health and social care provision may end up being different to what Sir David has recommended.

"One of the first tasks of our new joint chief executive will be to explore with all our partners, including our GPs, councillors and commissioners, whether this is a direction of travel all those responsible for services in our three boroughs would like to pursue."