The must-read stories and debate in health policy and leadership.

fourth “inadequate” rating in eight years follows a series of false dawns and broken promises at the country’s worst-rated mental health trust.

This is despite Norfolk and Suffolk Foundation Trust’s inclusion in the national failure regime and being buddied up with the “outstanding” East London FT in recent years.

In early 2020, the long-troubled trust was rated “requires improvement” by the Care Quality Commission but kept in special measures.

Now the latest twist in the seemingly neverending saga is that patient safety concerns identified in November and December 2021 have once again earned the trust the grim accolade of England’s worst-performing mental health trust.

Inspectors found most services had deteriorated but a severe decline in care was identified on children and young people’s wards. This service was previously rated “outstanding”. 

Inspectors warned of a lack of permanent nurses and doctors, and high use of restrictive interventions.

So what happens next? Regulators say a move into special administration, where national NHS officials would take control, is not being considered at the moment. 

Uncomfortable questions now face commissioners, with the long-suffering community calling for an independent inquiry into the trust’s repeated returns to special measures, and how such failures have been allowed to continue.

Bringing it home

An NHS chief executive has spoken candidly on Twitter about how the ambulance services crisis directly affected her last week.

Deborah Lee, chief executive of Gloucestershire Hospitals Trust, described how her husband drove her to accident and emergency with a suspected stroke because of concerns about long waits for ambulances within the region.

These concerns are absolutely justified: the South West’s ambulance service has been the worst performing in England by some distance this winter, with average waits for category two responses – which includes strokes and heart attacks – averaging 1:54 (hours and minutes) in March, and with 10 per cent of patients having to wait more than 4:32. The national average category two response last month was 1:01.

Gloucestershire Hospitals has experienced acute problems with “super stranded” patients, and Ms Lee argued the solution falls with the government to overhaul social care. She said this should include: “…training, development, pay reform and the professionalisation of care workers to build a sector that people want to join, stay in, and feel proud to belong to”.

She was clear the care she received was excellent, but posed the question: what if her husband wasn’t there and she had to wait for an ambulance? For many, this would be a dangerous reality.

Also on today

In The Ward Round, Annabelle Collins probes the factors behind the NHS’s Great Resignation, and in a comment piece Lord Ajay Kakkar says creating human-centred spaces that work alongside health professionals can ensure they deliver the art of care as well as the science of treatment.