North by North West: Bitter taste for ‘Marmite’ candidate

Typically, job applicants who are unsuccessful in an interview process do not want to talk publicly about that fact.

But John Ashton, the outspoken former director of public health in the North West, is not your typical applicant.

On Twitter last week, he posted a Private Eye clipping which had referenced his shortlisting for the position of chair for the Cheshire and Merseyside Integrated Care System, commenting that he had been rejected by the “usual suspects”.

It is understood he was the highest scoring candidate among the initial stakeholder panels, but the final decision panel ultimately decided not to appoint to the role (for a second time).

Instead, the ICS will continue with ex-national regulator David Flory as interim chair, while a third attempt to recruit to the role is prepared for the new year.

Mr Ashton is clearly angry about the decision. He told NxNW: “My track record speaks for itself in terms of my experience and suitability for the role.

“The feedback I’ve been given has suggested I wasn’t strong on the wider aspects of governance and accountability. But my track record - from blowing the whistle on Morecambe Bay, to helping expose the organ scandal at Alder Hey, and suspending breast screening in Carlisle - proves I can more than deal with NHS issues. So, I’m grossly offended by this suggestion.”

There was some strong support for Mr Ashton, particularly among some of the local government stakeholders. But this is an ICS where, to put it mildly, local government and the NHS are not always singing from the same hymn sheet.

One well-placed NHS source said: “John has an undoubted knowledge and skill, as well as a lot of loyalty in the area. But his qualities could be divisive as well, he’s a ‘Marmite character’.

“In many ways he’d be a much better appointment when they advertise it again next year. But what is needed now, in setting up the ICS, is real operational grip and [Mr] Flory provides that. In my view the three candidates shortlisted didn’t have the right sort of understanding on the operational side…”

This still leaves a bitter taste for Mr Ashton and his supporters, who question why Mr Flory was on the final interview panel, given the failure to appoint means he will now stay on longer as interim chair of C&M, and suggested he may want the job for himself.

NHS England’s regional directorate, which ran the process, said in a statement: “[Mr] Flory has agreed to continue as chair for Cheshire and Merseyside ICS on an interim basis at our request until March 2022 at the latest, and has been clear that he does not wish to take on the role in the long term.”

It is understood the panel consisted of six other senior figures, including regional director Amanda Doyle, and Mr Flory’s inclusion was in his capacity as permanent chair of neighbouring Lancashire and South Cumbria ICS (he currently holds both roles on a joint basis).

Mitigation

The final verdict from the Care Quality Commission on the leadership of Liverpool University Hospitals last week was pretty damning.

We don’t need to go over those findings again, but a word of mitigation.

Merging two acute providers is a tough proposition at the best of times, but particularly when there’s been little in the way of pre-existing collaboration, and when it’s effectively seen as a takeover by one provider.

Throw a global pandemic and all sorts of operational uncertainty into the mix, and you’ve got a situation that would seriously stretch the abilities and resilience of any leader.

There are clearly things the leadership at LUH should have done differently (not displaying “bias” towards the hospital they previously ran would have been a good start), but the difficulty of taking the trust through its early years while faced with some of the most severe covid pressures in the country should not be ignored.

Face-to-face rising

There was a significant increase in face-to-face GP appointments in parts of Greater Manchester in September.

Across Tameside, Stockport and Trafford, which are served by the coroner for Greater Manchester South, the proportion of face-to-face appointments rose by five percentage points compared to August, to 62 per cent.

This was a steeper rise than England as a whole, where the proportion increased from 58 to 61 per cent.

It follows multiple reports from the GM South coroner which linked the deaths of patients to the fact they had not been seen in the flesh by a doctor. Whether the scrutiny on local GPs sparked by the coroner reports has been completely fair or not, it could well be a contributing factor to the sharper rise.