The financial problems faced by NHS foundation trusts (FTs) will become worse over the next few years, according to Monitor.

The economic regulator’s review of FTs’ annual plans states that far from being a legacy of their NHS trust past, the financial malaise of FTs is set to intensify as their cost-cutting measures reduce their income.

Without positive service redesign, Monitor says, the 20% spending cuts planned by FTs over the next five years will not improve their financial health.

It notes that the financial gap between more and less successful FTs is widening, with the latter including many based at district hospitals, carrying PFI debts or in deprived areas.

“We expect an increasing number of trusts could be placed in significant breach for financial reasons,” said Stephen Hay, Monitor’s Chief Operating Officer.

According to the regulator, FTs “need to be making significant changes in the way services are delivered, including further service reconfiguration and consolidation of suppliers”.

The financial plans of FTs forecast a 1% decline in income overall in the next three years, with no increase in acute care activity (compared with an average annual growth of 4.5% in recent years).

The review predicts that at least 17 FTs will receive a red rating (indicating a serious risk of breaching their authorisation terms) in 2012–13. “We expect there will be more,” it warns.

According to David Stout, Deputy Chief Executive of the NHS Confederation, Monitor’s report shows an urgent need for service redesign towards more integrated and community-based care.

NHS East Riding of Yorkshire CCG and NHS Bassetlaw CCG have both appointed a chief officer (designate) as they gear towards authorisation.

Jane Hawkard has been confirmed in the role in Yorkshire with Phil Mettam taking the same position in Bassetlaw.

The two new recruits both come from NHS positions and backgrounds. Jane Hawkard previously held the position of Director of Strategy and Market Development for East Riding of Yorkshire PCT; Mr Mettam was previously the Deputy Chief Executive at NHS Bassetlaw.

The chief officer posts are being used for accountable officers of CCGs who are non-clinical. The appointments remain ‘designate’ until confirmed by the NHS Commissioning Board during the authorisation process.

The two CCGs are in the first ‘wave’ of authorisation with the NHS Commissioning Board.

A new specialist unit will give dementia patients in south Essex a halfway house between hospital and home, easing the transfer of care.

The Mountnessing Court healthcare facility in Billericay will be developed into a short-stay dementia treatment unit with 22 beds.

The flagship integrated care facility will bring doctors, nurses and therapists together with social care and mental health professionals, as well as Alzheimer’s Society workers.

A specialised care environment designed for people with dementia, it will provide 24-hour intensive treatment for patients staying up to eight weeks as a bridge between secondary care and independent life at home.

It will also treat patients being treated concurrently for a dementia and another medical problem, and will provide support for family carers of dementia patients.

The centre will be trialled from this autumn until January 2013. Patients will be drawn from Basildon, Thurrock , Rochford and Castle Point.

Ian Stidston, Director of Primary Care and Partnership Commissioning at NHS South Essex, said the unit would enable people “to have intensive support away from hospital” and that its purpose was to help patients “stay at home and live as independently as possible, for as long as possible”.

The Mountnessing Road facility was previously used as a day-care centre for elderly people with mental illness. It was faced with closure, but instead will be redeveloped as a specialist unit.

The NHS Commissioning Board (NHS CB) is struggling to fill vacant positions ahead of being authorised in March next year, board papers have revealed.

The Board’s ‘risk register’ indicated that it may “fail to populate its organisational structure” due to issues such as delays in organisational design and trade unions challenging the transition process.

A spokesperson for the Board said that establishing the organisation is a “complex task” and that the “critical thing is that we recognise and manage that risk”.

Board papers point towards four main challenges the NHS CB faces in its recruitment drive. Alongside issues with organisational design and challenges from trade unions, warnings were also raised around delays resulting from “disagreements with sending organisations regarding the nature of functional transfers” and the Board failing to secure “sufficient capacity” to manage the volume of recruitment needed.

To address these issues, the Board has been advised to analyse and strengthen its recruitment strategy and also develop a contingency plan should positions not be filled.

Kieran Walshe, Professor of Health Policy at Manchester Business School, said that a lack of recruitment may be down to individuals viewing a role with the NHS CB as inferior to their current position. “They (candidates) are often older, run pretty big organisations and the fact is they don’t want to be three rungs down the ladder in some outpost answering to the Commissioning Board,” he said.

The problems faced by the Board in recruiting suitable candidates were highlighted in July when it failed to appoint all of the required local area team directors. It has also been criticised by CCG leaders for delaying the authorisation process by failing to appoint managing directors of Commissioning Support Units.