Health Service Journal
Alastair McLellan

Alastair McLellan is editor of HSJ.

Nicholson seeks "legitimacy" amidst a storm of protest

15-Jan-2013
Sir David wants to communicate more directly with the public
Nicholson: leading hospitals to be reshaped by commissioning board

14-Jan-2013
The board will use its position as “a big, powerful commissioner” to reshape England’s largest teaching and specialist hospitals, says Sir David Nicholson.
Sir David embraces partnership but 'hasn't given up on grip'

14-Jan-2013
The NHS commissioning board will not operate a “hierarchy of deference” but its chief executive has not “given up on having a grip”.
Nicholson 'really sorry' for HR problems

14-Jan-2013
NHS Commissioning Board chief executive Sir David Nicholson has told HSJ he is “really sorry” for the poor experience suffered by NHS staff whose jobs are under threat as a result of the reforms. However, he claimed that given the scale of the change, the human resources pprocess had been a “reasonably well ordered thing”.
Nicholson: savings from integration 'already spent'

14-Jan-2013
Policy makers should beware of thinking that integrating health and care services will save money, Sir David Nicholson has warned.
Nicholson argues he should survive to implement Mid Staffs recommendations

10-Jan-2013
NHS Commissioning Board chief executive Sir David Nicholson believes he should survive any criticism levelled at him by the forthcoming report into care failings at Mid Staffordshire Foundation Trust.
A perfect storm of NHS scrutiny

10 January 2013
The quality of care in hospitals will come under fierce scrutiny after the Francis report is published
Why policing and school reform are inspiring Jeremy Hunt

12-Dec-2012
Hunt approaches his brief very differently from Lansley
Hunt: I'm open to NHS or private sector solutions

12-Dec-2012
Health secretary Jeremy Hunt has told HSJ it is “not my job to hold a candle” for either NHS or private sector providers when deciding what is best for patients.
'Technology QIPP' needed to transform NHS efficiency

12-Dec-2012
The NHS would be “crazy” not to try and realise the cost savings available through greater use of technology, health secretary Jeremy Hunt has told HSJ.
HSJ100 2012: Under 'Baron' Nicholson, a new health aristocracy takes shape

5-Dec-2012
Sir David Nicholson divides the world of healthcare leaders between “barons” and “knights”.
CSUs are heading for centre-stage

5-Dec-2012
The vision for commissioning support units is expanding under Bob Ricketts
The 17 most influential health leaders on Twitter

5-Dec-2012
This evening we publish the annual HSJ100
Can clinical decision support technology help hospitals deliver their QIPP goals? FREE HSJ webinar

30-Nov-2012
HSJ invites you to view an exclusive free webinar on how supporting your doctors in making clinical decisions delivers benefits at the hospital level. Register today.
The strategy that dare not speak its name gets a new champion

28-Nov-2012
Jeremy Hunt puts IT back on the agenda
Ofsted’s education in crisis management

28-Nov-2012
Is Jeremy Hunt envious of education secretary Michael Gove?
HSJ Awards 2012 - cutting-edge thinkers triumph

21-Nov-2012
Learn which projects won the most fiercely fought over accolade in British healthcare
HSJ Awards - exclusive best practice report

21-Nov-2012
The HSJ Awards best practice report details what every winner and finalist set out to achieve, how they did it and the savings gained
A turning point in health policy?

20-Nov-2012
Will we remember November 2012 as the month health policy began to forge a different path?
Hunt loosens the reins of power

13-Nov-2012
Hunt considers the mandate a test of the government’s commitment to loosening the reins
CCGs face old fears with desire for change

8 November 2012
Leaders believe they can make significant improvements in a year
Jeremy Hunt: More a Dorrell than a Lansley

1 November 2012
The need to assure and reassure is behind the commissioning board’s £12bn budget
Who are the most influential people in the NHS and health policy?

26-Oct-2012
The HSJ100 is our annual list of the most influential people in the NHS and English health policy.
Revalidation cannot be left to GMC alone

24-Oct-2012
Will boards have the influence necessary to make medics take revalidation seriously?
Transforming hospitals - FREE HSJ webinar

19-Oct-2012
Register now to view an exclusive webinar, looking at how hospitals will need to change over the next few years
Easton’s move stokes debate on private sector’s value to NHS

16-Oct-2012
Should Jim Easton be censured for taking a job at Care UK?
The alternative to centralisation

11 October 2012
In rural areas a different set of solutions to care delivery are being explored
Making integration happen

11 October 2012
Integration will be as important as competition, Jeremy Hunt has declared
We must resist the siren voices to achieve pay reform

2-Oct-2012
Pay reform in the NHS requires the wisdom of Solomon
Reconfiguration fever

27-Sep-2012
Leaders should expect little political aid on hospital change
Forty wasted years?

19-Sep-2012
Has the NHS done little to improve public health over the last 38 years?
Robert Francis should be the next CQC chair

11-Sep-2012
History is a guide for who should be Jo Williams’ successor
After Lansley

4-Sep-2012
The Lansley reshuffle is potentially the most significant sacking of a health secretary in living memory
The new NHS's greatest risk

23-Aug-2012
Reforms require the NHS to work harder on shared goals
‘Novel and contentious’

9-Aug-2012
The NHS rethinks its funding options in a developing picture which is far from uniform
CQC chair must consider her position

1-Aug-2012
Eyebrows appear raised over Dame Jo
Questions over Monitor’s role will be raised

1-Aug-2012
There is continued uncertainty over the mechanics of regulation
The unplanned racist impact of reform

25-Jul-2012
NHS must address representation struggle
Is scrutiny of care poorer the further you are from London?

25-Jul-2012
Scrutiny of care should not be impacted upon by geography.
Tough choices await CCGs hoping to reverse GP referral trend

18-Jul-2012
Time is short for CCGs and practices to collaborate.
Stability trumps choice in the birth of commissioning support

11-Jul-2012
Commissioning board is singing a different tune on CSSs.
Why so many vacancies? Time to stop the NHS talent drain

4-Jul-2012
Is the NHS heading for a leadership crisis?
South London’s ‘failure’ leaves the big questions unanswered

26-Jun-2012
Govt has sent a warning shot to struggling trusts.
Sharing responsibility may be uncomfortable work for medics

22-Jun-2012
Alastair McLellan’s leader.
Leaders can help detoxify the BMA strike

19-Jun-2012
The strike’s real threat is to relationships in the NHS.
Lansley expects 'nearly all' CCGs to be authorised by deadline

14-Jun-2012
Andrew Lansley has declared that he expects to see close to 100 per cent of clinical commissioning groups fully authorised by next April.
GPs 'absurd' to walk away from CCGs over pensions

14-Jun-2012
Andrew Lansley has claimed it would be “absurd” for GPs to walk away from clinical commissioning groups because they were angry over the government’s refusal to improve its pension offer.
Can light-touch Lansley really avoid the toughest decisions?

14-Jun-2012
Alastair McLellan interviews the health secretary.
'Budget for health' to set out future ambitions

14-Jun-2012
Andrew Lansley hopes to establish an annual “budget for health” which will become the parliamentary set piece debate on the service.
Lansley: management cuts to slow after 2012

14-Jun-2012
Aggressive cost saving will mean new NHS organisations will not have to make further deep cuts in management and administration spending from next year, Andrew Lansley has revealed to HSJ.
Mid Staffs recommendations unlikely to clash with policy

14-Jun-2012
Health secretary Andrew Lansley has told HSJ that he is “confident” most of the recommendations of the inquiry into care failings at Mid Staffordshire Foundation Trust will be “delivered within the legislative framework we’ve got”.
Public engagement with service information is key test of choice

31-May-2012
HSJ editor Alastair McLellan’s leader.
Stop wasting money on innaccurate data

25-May-2012
The importance of being accurate.
We should expect more questions than answers from good leaders

23-May-2012
Health leaders will need to adopt a new style.
The data debate needs a dose of pragmatism

17-May-2012
Things could quickly turn sour despite best intentions of data-sharing plans.
GPs vs MPs: the ‘new’ battle ground for a redesigned NHS

17-May-2012
Will reconfiguration be any different this time around?
How many care scandals are we missing as reform rolls on?

9-May-2012
Reforms’ upheaval threatens care quality and safety.
The DH continues to dance around the issue of CCG freedoms

26-Apr-2012
What will CCGs do with their “assumed liberty”?
Agenda for Change was built for a feast. How will it cope with famine?

19-Apr-2012
This year’s Budget puts the squeeze on pay.
'The NHS could miss the next care revolution'

19-Apr-2012
HSJ interviews GE Healthcare president John Dineen.
Commissioning board mandate must set out a clear vision

12-Apr-2012
CCGs should be wary about what comes next.
New NHS system threatens a tsunami of hospital mergers

29-Mar-2012
A wave of reconfiguration is on the horizon.
PM declares 'national crisis' over dementia care

26-Mar-2012
The prime minister has declared that rising rates of dementia are “a national crisis” and launched a major drive to improve the lives of sufferers and their carers.
Leaders must now give the NHS a sense of endeavour and purpose

22-Mar-2012
Looking on the bright side of the bill can bring about positive change.
HSJ…more for healthcare leaders

15-Mar-2012
One thing unites HSJ readers, whether they have a clinical or non-clinical background, work in the NHS or provide services from the private sector: they are all leaders.
Experienced GPs and managers can give CCGs the best start

14-Mar-2012
Commissioning will, at first, need experience at the helm.
Out of CSS failure will come a ready-made market

9-Mar-2012
How important is it that CSSs are set up along commercial lines?
The fate of unsustainable services is back in the hands of the centre

7-Mar-2012
Alastair McLellan’s editorial.
Exclusive: public split over use of private firms in NHS as Labour doubles poll lead on health

5-Mar-2012
The English people are split down the middle on the use of private companies to provide NHS services, according to exclusive polling data compiled for HSJ.
Failure to limit expectations is blighting NHS regulation

1-Mar-2012
Did Cynthia Bower fail to control the expectations of her commission?
Are you brave enough to fail?

23-Feb-2012
HSJ begins new interview series with economist Tim Harford.
CCGs in the limelight as NHS reform row gets brutal

22-Feb-2012
Alastair McLellan’s editorial.
The Health Bill plan B is dead, but plan C lives on

16-Feb-2012
David Cameron has made passing the Health Bill a matter of confidence – making it close to impossible the legislation will fail. We now need to ask what kind of bill will be passed and what will happen afterwards.
Does the government really have a Plan B for NHS reform?

9-Feb-2012
As the Health Bill staggers through the House of Lords and opposition grows to it in a daily basis, the question is reasonably asked whether the government has a Plan B.
Government won't enjoy efficiency gained from public sector borrowing

9-Feb-2012
Can efficiency be achieved through increased public spending?
Cameron's comparison to Blair only highlights the differences

9-Feb-2012
Miliband uses HSJ’s joint editorial to challenge Cameron over reform.
'Political bravery’ required to keep the NHS ‘the most open health system in the world'

8-Feb-2012
The NHS is “the most open health system in the world” according to the government’s new public data transparency tsar, but only a mix of urgency, political bravery and public and clinical engagement will keep it that way.
The NHS deserves a better, more open debate over health reform

31-Jan-2012
The Health Bill enters the crucial report stage in the House of Lords next week amid huge controversy. To mark this, the BMJ, HSJ and Nursing Times have, for the first time, cooperated to publish the same editorial.
A weak private sector is bad news for the NHS

26-Jan-2012
The future for the private hospital sector is not a pretty one, as our exclusive analysis of Laing and Buisson’s authoritative annual market review reveals, and this conclusion prompts two questions.
The complexity of competition rules creates confusion and risk

18-Jan-2012
Those who worry about the commercialisation of services for NHS patients often point to problems created by privatised utilities or the unholy mess that is the West’s banking sector.
Ministers must slow down to avoid another Mid Staffs

12-Jan-2012
What did the newly minted coalition government describe in May 2010 as “a champion for patients”? The answer, of course, was primary care trusts.
Cameron is tending self-inflicted wounds

11-Jan-2012
One thing is clear from the government response to the NHS Future Forum. Contrary to press reports, no “order” has been given to deliver “integration of health and social care”.
NHS market could fragment further, warns Supply Chain CEO

4-Jan-2012
The “fragmented” way the NHS is developing could make it harder for it to make savings on procurement, the chief executive of NHS Supply Chain has warned.
2012: what now for the NHS?

4-Jan-2012
What has 2012 got in store for the NHS? Here are HSJ’s predictions for the year ahead.
The mediocre will be the only losers if pay is reformed fairly

15-Dec-2011
George Osborne has instructed the NHS pay review body to investigate the case for reforming the service’s national pay deal. The chancellor wants it to become more “market facing in local areas”.
Commissioning board chair praises NHS’s 'spectacular' record during last decade

9-Dec-2011
NHS Commissioning Board chair Malcolm Grant began the first formal meeting of the organisation by praising the “spectacular increase” in public support for the service under the Labour government.
HSJ100: In a time of transition, power lies in David Nicholson’s iron grip

7-Dec-2011
The HSJ100’s job is to predict who will wield the greatest influence over health policy and the NHS in the coming 12 months.
Don’t be squeamish: learn to embrace innovation

7-Dec-2011
Innovation, Health and Wealth, the report prepared by NHS South of England chief executive Sir Ian Carruthers, is a powerful and long overdue document.
An unflinching framework in the face of relentless pressure

29-Nov-2011
Today’s autumn statement painted a gloomy picture of the economy in 2012. By the time the Chancellor rose, NHS leaders had already begun to come to terms with an operating framework that sent a similarly grim message.
Exclusive: Government to link GP and hospital data

28-Nov-2011
The relationship between the quality of GP and hospital care is set to be revealed for the first time by the publication of data which will detail the complete patient pathway.
Make an ‘impossible job’ easier by following a NICE example

24-Nov-2011
“I don’t mind people thinking I’m incompetent, although I don’t want them to,” Care Quality Commission chief executive Cynthia Bower told HSJ this week.
Maximum waits matter as much as minimum ones

17-Nov-2011
Reading between the lines of the blustering, disingenuous and politically motivated government announcement banning “minimum waiting times”, a more interesting theme emerges.
Winners demonstrate the power of unity

16-Nov-2011
The HSJ Awards – the largest celebration of health service excellence in the UK – is always a cause for cheer. However, this year, its arrival feels particularly positive.
Legal challenges threaten service redesign

11-Nov-2011
Royal Brompton and Harefield Foundation Trust’s successful judicial review of the national consultation into the reconfiguration of paediatric cardiac services will send a shiver down the backbones of those charged with reshaping the English NHS.
Change is inevitable, but more confusion and conflict is not

3-Nov-2011
The last thing most HSJ readers want to hear about is the prospect of further change. Unfortunately the nature of these reforms almost guarantees it.
Where are all the female clinical leaders?

3-Nov-2011
Of all the unwelcome consequences of the NHS reforms, perhaps the most unexpected is HSJ’s revelation that the leadership of clinical commissioning will be overwhelmingly male.
HSJ interview: Clayton M Christensen, author of The Innovator’s Prescription

3 November 2011
The author of the Circle Prize for Inspiring Innovation-winning book, The Innovator’s Prescription, talks to HSJ about disrupting healthcare.
The many questions we still need to answer on integration

26-Oct-2011
Integration: what does it mean to you? For some it is an antidote to the evils of competition, for others a way to create a sustainable future for shaky organisations.
CCG support vision will calm anger but spark controversy

19-Oct-2011
Last week Sir David Nicholson summoned the 51 primary care trust cluster chief executives to a meeting at which he set out how they should address the challenges ahead. The audience listened dutifully, but the tension in the room was palpable.
Rewriting the rules of the blame game

13-Oct-2011
An honest debate about the challenges and tensions of making management decisions in the NHS is hard to find.
Pension squeeze is another victim of inept NHS reform

13-Oct-2011
“I’m not touching that, it’s a quagmire,” said the health minister fleeing from HSJ’s question at last week’s Conservative Party conference.
DH chases up service changes with an undisguised urgency

5-Oct-2011
The Department of Health’s report on the NHS’s record in the months April to June presents an impressive list of achievements and the NHS staff responsible for them should rightly feel proud. But look closer and a less reassuring picture emerges.
'Only mugs work in commissioning’: tackling the management brain drain

29-Sep-2011
Of all the postgraduate courses in the country, places on the NHS management training scheme are among the most fiercely contested.
NHS giants sound warning of acute financial turmoil

22-Sep-2011
The leafy villages of Great and Little Shelford lie around five miles south of Cambridge. Shelford boasts a rich history reaching back to the Domesday Book, but it is also has claim to fame in NHS circles.
Clare Gerada ups the stakes in her fight to ‘save’ the NHS

14-Sep-2011
The unlikeliest and, perhaps, most powerful alliance affecting the delivery of the NHS reforms is between Royal College of GPs chair Dr Clare Gerada and what some might term the “old guard” of NHS managers who have wielded the greatest influence over the last decade.
Why caution on hospital failure still has its price

8-Sep-2011
This week the government looked into the abyss of hospital failure and shuffled nervously back from the edge of the precipice.
Liberating Ideas Award 2011: can your idea benefit the rest of the NHS?

8 September 2011
Great ideas drive improvement in the NHS. Enter your organisation into the second Capgemini and HSJ Liberating Ideas Award now.
Fear of failure or staff fury may drive further job cuts

1-Sep-2011
During the summer our HSJ Local service has been reporting on plans to reduce hospital workforces. This week we reveal Aintree University Hospital Foundation Trust’s decision to remove 200 posts during each of the next three years.
Rival factions fight for influence in Future Forum’s second coming

24-Aug-2011
Why continue with the NHS reform listening exercise? The NHS is already changing with a momentum no report is likely to affect.
Future Forum adds integrating care as priority

24-Aug-2011
Integration within and across the health and social care sectors has been named a new priority area for the NHS Future Forum, whose second phase of work was launched by the prime minister last week.
Exclusive: David Cameron launches second phase of NHS reform listening exercise

18-Aug-2011
Prime minister David Cameron will today launch the latest stage in the listening exercise designed to inform the development of the government’s NHS reforms.
Distrust and pragmatism inform softly-softly authorisation plan

18-Aug-2011
There is one sentence in the government’s draft authorisation process for clinical commissioning groups which highlights the atmosphere of distrust in which the new arrangements are being negotiated.
Getting clinicians to speak up is the real key to fighting poor care

28-Jul-2011
To the list of life’s certainties, Benjamin Franklin might have added the change from strong to light-touch public sector regulation and back again.
Lansley’s defence of management cuts is disingenuous and dangerous

14 July 2011
“I try to avoid saying things that are capable of misinterpretation,” Andrew Lansley told HSJ last week.
Lansley heralds change in size and role of acutes

13-Jul-2011
Andrew Lansley has used an HSJ interview to signal significant changes in the size and role of acute hospitals, although he insisted there was no certainty that hospitals would close.
Exclusive: Lansley says hospitals exempt from 'over-managed' claim

8-Jul-2011
Andrew Lansley has used an exclusive HSJ interview to exempt the acute sector from his criticism that the NHS is over-managed.
Transparency offers a chink of light in a dark week for reform

6-Jul-2011
You should not mistake Professor Roger Boyle’s outspoken criticism of the health reforms as the demob happy words of a man about to retire.
Save now, pay later: the pension cuts folly

30 June 2011
Not for nothing was public service pensions commission chair Lord Hutton placed at number 28 in HSJ’s list of the people with the most influence on the NHS last year.
High trust, robust challenge and a firm grip are key to success

30 June 2011
Failing NHS organisations get much more attention than successful ones, despite the fact that the latter far outnumber the former.
Exclusive: NHS faces 'big problem' if reform timetable slips - Nicholson

22-Jun-2011
The NHS faces a “big problem” if there are further delays to the timetable for developing clinical commissioning groups or moving to an all foundation trust system, NHS chief executive Sir David Nicholson has told HSJ.
Nicholson’s power is unrivalled – so is his responsibility to lead

22-Jun-2011
This week is expected to see the publication of the revised Health and Social Care Bill. Health secretary Andrew Lansley has written that it will contain more than 150 amendments. It would be only mildly surprising to find one of them enshrining in law Sir David Nicholson’s position as NHS chief executive.
Exclusive: NHS efficiency drive won’t close whole hospitals, says Sir David

22-Jun-2011
No “whole hospital” will have to close as a result of the drive to find £20bn of efficiencies from the NHS budget, NHS chief executive Sir David Nicholson has insisted to HSJ.
The government’s changes will only delay the tough decisions

15-Jun-2011
One overarching conclusion can be reached from the changes to the government’s reforms: there will be a continuation of the planning blight that has afflicted the health service since the decision to scrap primary care trusts without thinking through the implications.
Reform changes may threaten what little progress is being made

8-Jun-2011
What is the real impact of GP consortium commissioning on NHS services? Not the claim and counter-claim of the political battle, which is largely focused on imagined utopias or dystopias of the medium term, but the change being experienced by patients and staff?
@HSJeditor’s guide to the Health Policy Twitterati

1-Jun-2011
Twitter is full of people mouthing off pointlessly about health reform or simply linking to their latest blog. But there are also a good number of tweeters with something interesting to say and who take an active part in debate. Here’s my pick. I’d be grateful for other suggestions.
The NHS must plan for a decade of austerity

1-Jun-2011
After decades of underinvestment, the NHS required the turbocharging provided by the 2002 Budget. The resulting flow of funds did much good. However, with the benefit of 20/20 hindsight many would argue the money could have been spent more efficiently – although there would be considerable dispute about what should have been done differently.
The CQC is feeling the pressure as rising uncertainty takes its toll

26-May-2011
There has been so much focus on the future role of Monitor that almost no attention has been paid to how the NHS’s other regulator, the Care Quality Commission, is coping with the challenges of reform and tighter budgets.
Celebrate, don't denigrate: the case for management is clear

18-May-2011
“Leadership and management in the NHS matter and the role of managers should be celebrated and not undermined.”
Exclusive: Britnell responds to 'privatisation' storm

17-May-2011
“The vast majority” of NHS care will “always and quite rightly” be provided by “public sector organisations and paid for out of taxation”, according to the man at the heart of a storm over accusations of NHS privatisation.
Service sweats over plans B, C and D as pause takes its toll

12 May 2011
The NHS is paying a heavy, although largely unseen, price for the “pause” in the government’s health reforms.
Benefits lost as C-word remains a taboo

11-May-2011
Do you remember the debate over the future of the US healthcare system that dominated the last Presidential election?
Cameron phones friends to help answer tricky reform questions

5 May 2011
It is a year since the general election that brought the coalition to power and Andrew Lansley to Richmond House.
PCTs are dead. Long live the PCT cluster?

27-Apr-2011
Here’s a quiz for you. What do the following numbers - 581, 331, 162, 62 - represent?
Inquiry adds to the toxic reform mix

21 April 2011
Cynthia Bower, chief executive of the Care Quality Commission, appeared at the Mid Staffordshire Foundation Trust inquiry on Monday. Ms Bower was previously chief executive of NHS West Midlands, responsible for monitoring the troubled trust.
Straggling organisations set to slip into crisis

20-Apr-2011
The popular perception is that the fortunes of the NHS rise and fall on a national basis. HSJ readers will know the true picture is one of variation – often stark – between organisations and regions.
Andrew Lansley: an enemy of reform?

14 April 2011
HSJ’s increasingly unfashionable, strained and conditional support for Andrew Lansley continuing as health secretary is predicated on two beliefs.
Imperial's problems are the first rumblings of a perfect storm

13-Apr-2011
HSJ was once asked by the health secretary what could prevent his reforms from continuing. We suggested a major hospital getting into significant financial trouble and those troubles being successfully linked by opponents to his reforms.
Why Andrew Lansley should stay - and why he might go

5-Apr-2011
Andrew Lansley must go. That is the demand of many of the opponents of the government’s health reforms. They are wrong.
Action on the ground is proving as fascinating as Westminster tussles

31 March 2011
There are two narratives running in parallel on the current NHS reforms. Within Whitehall and Westminster and among the health policy chattering classes debate rages over the exact intention of each clause of the Health Bill.
Transparency tsar could spark a revolution

31 March 2011
When Andrew Lansley became health secretary he gave a series of presentations which all began by stressing how the new government would increase patients’ control by giving them more choice and information.
Cut public service data opt outs, says incoming 'transparency tsar'

31 March 2011
The man slated to be the government’s new “transparency tsar” believes “no-one who uses a public service should be allowed to opt out of sharing their records”.
One more sign that we may miss the expertise of PCTs

24 March 2011
While the NHS accelerates towards an uncertain future, primary care trusts are braking hard on activity.
Pay attention to the sound of the crowd

24 March 2011
“The wisdom of crowds” was one of the buzz phrases of 2004. The theory was that social media and other digital services allowed opinion to be aggregated quickly and effectively to drive real world decisions.
Performance bonuses: a fair swap for public service pension reform?

17 March 2011
“There is a much stronger case for linking pay to performance at the senior levels of public organisations, as opposed to the rest of the workforce”.
2013 has already arrived for some regions

17 March 2011
It is an iron rule of NHS reform that development is both geographically patchy and concentrated in certain areas - look at the progress made in tackling heart disease compared with the record on sexual health, or how performance in the South West has consistently outstripped other regions.
'Introspective' NHS fearful of change

10 March 2011
The NHS has an “introspective, monopolistic culture” in which staff are unwilling “to accept the inevitability of change”, according to a former Labour minister who was given a key public spending reform role by the coalition government.
Is Andrew Lansley 'screaming inside'?

9-Mar-2011
A commissioning consortium in the west country declares it “does not believe in the purchaser-provider split”, the Foundation Trust Network warns of “serious financial stress” and the membership of the British Medical Association warms up to declare outright opposition to the Health Bill.
Regulating managers will not resolve the issues they face

3 March 2011
Is the regulation of health service managers a good idea? The man who watches the watchers - Harry Cayton, chief executive of the Council for Healthcare Regulatory Excellence - does not think so.
MPs could teach GPs a lesson in prudence

3 March 2011
“It sounds like an MPs’ expenses type thing and that’s what we’ve got to avoid.” The words of Clare Gerada, Royal College of GPs chair, may prove to be prophetic.
Alcohol harm is causing a nasty headache

24 February 2011
The impact of alcohol on the nation’s health is beginning to shade from a worry into a crisis. Dr Foster Intelligence’s exclusive analysis for HSJ shows that 7 per cent of hospital admissions are related to alcohol.
Consortia to be authorised in stages, Sir David tells HSJ

22-Feb-2011
Commissioning consortia could be authorised in degrees and should not “make” their own commissioning support, NHS chief executive Sir David Nicholson has told HSJ in a wide-ranging interview.
Competition should never be first choice, but it could be best

17 February 2011
Whether you believe competition to provide care for NHS patients is per se a good or bad thing is largely a matter of political bias. The evidence on either side is almost transparent.
If accountability counts, its value must be recognised

10 February 2011
Should we worry that some primary care trust chief executives who are offered more junior roles in PCT clusters, losing their accountable officer status in the process, cannot opt for redundancy instead?
Local performance is the key to the future of the NHS

10 February 2011
Since May the spotlight has been resolutely on changes in national health policy. The entry of the Health Bill into Parliament marks the beginning of the end of that phase. What will matter increasingly is how the NHS at a local level deals with the twin challenge of reform and the £20bn savings target.
Is a narrative for complex health reform impossible?

3 February 2011
Two snapshots from a day in the life of one A Lansley, health secretary.
The NHS might be being rewired, but its electricity runs to much the same effect

24-Jan-2011
The Health Bill has set a new record as the largest piece of NHS legislation ever tabled. Health secretary Andrew Lansley described it as “evolutionary” – the mind boggles at what he would consider “revolutionary”.
‘Brave’ Sir David stresses freedoms and delivery

19-Jan-2011
As the NHS drowns in reform, the danger of distraction grows.
Commissioning board should run large scale 'experiments' - UnitedHealth head

18-Jan-2011
The NHS Commissioning Board should run a series of large scale “experiments” designed to test solutions to the growing burden of chronic disease, UnitedHealth’s president of global health Simon Stevens claimed this week. Successful programmes should be made “part of the NHS benefits package”.
Private sector takeover not as imminent as some may have it

18-Jan-2011
The week began with a media feeding frenzy around the government’s NHS reforms created by the imminent publication of the health bill. Dire warnings were ten a penny, while the PM adopted a Thatcherite “no alternative” stance.
'Conspiracy of silence hides true extent of poor GP performance'

13 January 2011
Andrew Lansley claims primary care trusts had to be abolished because they failed to commission effectively - an arguable accusation.
'Now with 25pc more reason to believe'

13 January 2011
“Hope is a key differentiator between those NHS organisations that succeed and those that don’t,” says the NHS Institute’s Helen Bevan. She adds, “the driving force of hope is belief” - belief that things can be improved.
Nicholson is master of all he surveys after surprise decision

20-Dec-2010
Did you declare yourself unsurprised by the appointment of Sir David Nicholson as the first chief executive of the NHS commissioning board just before Christmas? Then you were either fibbing or Andrew Lansley.
'Lansley may play down his reforms' radicalism, but this does not involve big changes to his plans'

15-Dec-2010
“Some have argued Liberating the NHS constitutes an unwise distraction from the quality and productivity challenge facing the NHS.
Battleship Lansley ploughs on through the fog of reform

9 December 2010
HSJ readers will be familiar with the tensions inherent in the government’s reforms which are now beginning to leak into the public ken.
White paper let down by speedy schedule

1-Dec-2010
The public health white paper is something of a an anticlimax. Government plans for improving the country’s wellbeing may well prove to be significant, but we will have to wait until well into 2011 to find out.
Circle’s success at Hinchingbrooke is more likely to be cultural than commercial

1-Dec-2010
What will we learn from private provider Circle’s success in becoming the preferred and only bidder for the contract to manage Hinchingbrooke Health Care Trust?
GPs and government battle for custody of white paper reforms

25 November 2010
The struggle for the soul of the reforms is intensifying as the outline shape of the new landscape clarifies.
Commissioning board chief exec not in post until October

19-Nov-2010
The chair and the chief executive of the proposed independent NHS commissioning board are unlikely to take up their roles until autumn next year, HSJ understands.
What Dorrell says matters, and his message to the NHS is clear

17-Nov-2010
House of Commons health committee chair Stephen Dorrell made an electrifying intervention into the NHS reform debate last Thursday.
Lansley accelerates his plans as Labour’s opposition falters

11 November 2010
The government’s reforms are picking up pace.
An American Dream we should believe in

11 November 2010
The NHS too often looks to the US for inspiration, encouraged by a shared language and the size of the American healthcare system.
The new mortality indicator suffers from mixed messages

4 November 2010
The debate over how hospital mortality should be measured and whether those measures reveal anything useful has rumbled on for the last decade.
GPs stung by maternity services rebuff

4 November 2010
Who should commission maternity care? Health secretary Andrew Lansley has decided it should not be part of the “great majority” of services that GPs will eventually be responsible for.
HSJ Finance: helping you achieve NHS efficiency

21 October 2010
This week HSJ introduces a new section in the magazine. HSJ Finance has two goals: to explore how increasing financial pressures are impacting on the NHS, and to plot the developing relationship between the service and the private sector.
The coalition’s honeymoon is in danger of being called off

7 October 2010
Momentum is a priceless asset in public sector reform. New governments tend to have momentum - commonly called “the honeymoon period.”
Your idea could redefine the health service

7 October 2010
What is the big idea that will guide and inform the development of the NHS throughout the next decade?
The NHS has too many hospitals - something’s got to give

30 September 2010
Bristol, Alder Hey, Mid Staffordshire; some hospital trusts are forever synonymous with failures which shone a light on problems found throughout the NHS. Could South London Healthcare Trust and Heatherwood and Wexham Park Hospitals Foundation Trust be about to join them?
Lansley acknowledges lack of readiness for GP commissioning

30 September 2010
GPs need to significantly overhaul their skill sets before they embrace commissioning.
The hurricane of protest over NHS pay can be calmed by honest debate

23 September 2010
How much, in this age of austerity, should NHS staff or contractors be paid? Using the number of comments on HSJ’s website as a guide, no subject is of greater interest or importance.
Conflicting messages from the top hint at growing resistance

16 September 2010
Have the tone of messages from the NHS chief executive and health secretary ever been as different as those emerging from Sir David Nicholson and Andrew Lansley? At last week’s health questions in the House of Commons, ministers got stuck into “pen pushers”. Contrast this language with Sir David’s latest letter to the service.
Health Hotel reopens for 2010

16 September 2010
The first real acid test of how closely the coalition’s junior partner is allied to the proposed health reforms will come next week at the Liberal Democrats’ annual conference in Liverpool.
It’s not just commissioning – who will fill the PCT vacuum?

9 September 2010
Margaret Angier had news for the readers of the Sheffield Telegraph. The chair of a local mental health group, Ms Angier wrote to the paper about the government’s health reforms.
The health community remains doubtful of Cameron’s big idea

2 September 2010
Does the “big society” have any relevance to the future of the NHS?
HSJ100: Staying power is at the heart of NHS influence

2 September 2010
As we prepare our list of the most influential people in health in 2010, Alastair McLellan and Darius McQuaid look back at who has wielded most power in the NHS during the last four years
NHS spending debate focuses on the wrong type of consultant

26 August 2010
Why is health secretary Andrew Lansley still acting like an opposition politician? That is the question raised by the government’s haranguing of primary care trusts for their use of management consultants.
The accountability of overspending GPs

26 August 2010
The British Medical Association has declared GP consortia must be “democratically accountable” to practices. And they “should act with integrity and leadership when considering the accountability of practices”.
Hospital Guide consultation - share your views

23-Aug-2010
HSJ readers have until 3 September to help determine the metrics that will be used in this year’s Dr Foster Hospital Guide.
Alarm bells sound as financial scrutiny falls victim to the cuts

19 August 2010
Amid the sound and fury surrounding the abolition of the Audit Commission there was little comment on how it would affect the NHS.
Dr Foster consults on the Good Hospital guide

18-Aug-2010
HSJ readers have been given the exclusive opportunity to help determine the metrics which will be used in this year’s Dr Foster Hospital Guide.
Help shape the 2010 Hospital Guide

18-Aug-2010
The history of Dr Foster’s Hospital Guide is a microcosm of the last decade’s debate over healthcare quality.
World class commissioning: this ridiculed plan might just be working

12 August 2010
World class commissioning arrived too late and burdened with a name that virtually guaranteed ridicule. But, unfashionable though it may be to say, it is beginning to deliver results.
Under the radar guidance ends hospital closure moratorium

5 August 2010
The revised guidance on hospital reconfiguration was slipped out last week at the height of the summer holiday period.
Free NHS Choices to meet public need

5 August 2010
The internet’s unequalled capacity to inform and communicate with the public should have been comprehensively exploited by the NHS.
Nicholson warns of tightening central grip over PCTs and providers

22 July 2010
The Department of Health will seek to assert strong financial controls over foundation trusts as well as primary care trusts during the transition period to implement last week’s health white paper.
Sir David praises 'heroic' PCT and SHA managers

22 July 2010
Sir David Nicholson is “incredibly proud” of the “remarkable work” done by primary care trust and strategic health authority managers.
‘Heroic’ NHS managers get their due from friend and foe

22 July 2010
“Heroic” is not a word often used to describe NHS managers, so well done to NHS chief executive Sir David Nicholson for praising the individual efforts of primary care trust and strategic health authority leaders.
Managers have been unfairly served by the rushed reforms

13-Jul-2010
“In the crucial area of public service reform, we have found that Liberal Democrat and Conservative ideas are stronger combined… You have a united vision for the NHS that is truly radical: GPs with authority over commissioning… elections for your local NHS health board.”
NHS staff to find out if their jobs are at risk by September

13-Jul-2010
NHS staff facing potential redundancy or a change in their roles as a result of the government’s reform plans will be informed by the end of September.
It’s public health, Jamie, but not as we know it…

8 July 2010
What is Andrew Lansley’s favourite phrase?
Take a bow as HSJ scoops awards glory

24 June 2010
Last week, HSJ was named Media Brand of the Year in the Periodical Publishing Association awards.
Andrew Lansley challenges a decade of NHS spending

23-Jun-2010
Health secretary Andrew Lansley assures HSJ editor Alastair McLellan that funding is still to rise annually - but the scale and rationale for any increases will differ vastly from recent years
We embrace NHS reform – but not the idea of a clinical takeover

17-Jun-2010
Last week’s leader explored the risks of giving GPs a central role in commissioning.
Dangers of putting GPs in charge outweigh the rewards

10 June 2010
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NHS reputation is on a par with Iceland chain

3 June 2010
The English NHS has a public reputation roughly on a par with frozen food retailer Iceland or the UK media sector, according to a unique analysis exclusively obtained by HSJ.
We need the NHS Confederation – now here’s the sort of leader that it needs

3 June 2010
Steve Barnett’s resignation as the chief executive of the NHS Confederation is a cause for sadness - he is a well-liked man - but it is also an opportunity.
McKinsey report: unthinkable solutions set scene for NHS cuts

2-Jun-2010
What lies behind the governments’s decision to publish the McKinsey report into NHS cost savings this week?
20 questions the coalition must nail if its agenda is to succeed

27 May 2010
The coalition has got off to an impressive start in rolling out its health policy. Speed and consistency have been to the fore. Judging from the feedback on HSJ’s website, the broad sweep of policy is seen as logical and appropriate to the challenges ahead.
Dare one step further and keep Lansley in post for the full term

20 May 2010
Andrew Lansley is the best prepared health secretary of modern politics. During his time as shadow health spokesman, Labour went through five health secretaries.
Coalition’s uncertain future threatens NHS renewal

12-May-2010
The new prime minister has declared his determination that the Conservative Liberal coalition will deliver stable government. The planned early legislation to introduce a fixed term parliament would mean that the prospect of another election in the next 24 months receding rapidly.
NHS managers are not overpaid – but their rewards must reflect results

6 May 2010
Health service managers are comfortable with - or at least resigned to - the paradox of rising public expectation and plunging public regard.
National GP referral guidelines are needed to reduce inequalities

29 April 2010
HSJ’s analysis of the first national collection of patient reported quality measures confirms what has long been suspected: better off patients undergo surgical procedures sooner after they develop health problems than poorer patients.
Elected PCT boards - we're not ready

29 April 2010
If the Liberal Democrats hold the balance of power in a hung parliament, then we now know what their number one health bargaining chip would be.
NHS pay: will you dare to lead by example?

22 April 2010
Will the post-election period bring radical pay reductions and pension reform to the public sector similar to those being experienced in Ireland?
Foundation trusts: new approach needed to unblock the pipeline

22 April 2010
The financial discipline that comes with foundation status is alone an argument for moving all NHS trusts in that direction. A powerful secondary reason is the greater clarity given to the accountability of board directors.

Alastair McLellan

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