CEO warns against ‘top slicing’ acutes for ‘well meaning’ neighbourhood schemes

Large acute trusts are shouldering unreasonable risk because their funding has been “top sliced” to pay for “well meaning” but unproven “neighbourhood health” schemes, a leading London CEO has told HSJ.

Shane DeGaris, of Barts Health Trust, said the financial transition to realise the hospital-to-community “shift” was currently “not clear”, and much of the risk was with with hospital providers.

Mr DeGaris said his £2.7bn organisation was “supportive” of neighbourhood health, and in “live discussions” on how responsibility for it can be divided up in North East London.

But in an interview with HSJ, he warned his and other acutes were facing potential deficits, with the funding regime becoming “increasingly bad” for them.

Mr DeGaris said his trust “fully supports” the shift of services from hospital to community, but added: “There’s going to be a huge chunk of work still going to be required to do in hospitals…

“[We need to make sure] all the stranded costs aren’t there for the hospitals in a world where accountability now is all about individual trusts.

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Source: HSJ, 9 July 2026