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

Low value contracts

This week’s story on a children’s autism service in Staffordshire brings up an often-ignored question when it comes to failing services – what role did the commissioner play?

Evidence uncovered by HSJ has suggested commissioners in South Staffordshire failed to act on safety issues raised about its children autism services until this year, despite concerns being raised as early as 2015.

Over 2015 and 2018 similar themes have arose in regulator’s reviews, parents’ complaints, and a clinical commissioning group review which found services were “inadequate”.

So why were providers allowed to continue offering the same subpar services for at least three years?

One suggestion is that commissioners failed to properly quality assess and monitor services to the size of the contract. However, they did admit to a parent earlier this year the services had previously had “minimal” visits due to the fact the contract was of “limited value”.

This is perhaps a justifiable argument but there were clearly red flags about the service since 2015, so what was the real reason for commissioner’s inertia?

It is difficult to answer with any certainty but readers may wonder whether it was related to the fact that, until relatively recently, autism services were quite a low priority both on the national agenda and local.

New digital department NHSX was forced to remove a job advert for a senior IT role last week after it faced criticism for excluding people from black and minority ethnic backgrounds.

NHSX officials confirmed the application process for the chief nursing information officer role has been paused so the criteria in the advert could be amended “to ensure they fit with NHSX values”.

The advert attracted criticism for stating hopeful candidates must have “proven and significant experience at director level”. By putting this in as an “essential” criteria it significantly limited the number of BME candidates eligible to apply for the role as “very few BME people have reached director level”.

Senior manager for the NHS workforce race equality standards, Owen Chinembiri, responded to the job advert on Twitter, saying: “If significant board level experience means more than three years, less than eight BME nurses in the NHS can apply for that job. Happy to be corrected.”

The Shuri network – a network of BME women working or interested in digital health – was tagged in the original NHSX tweet advertising the role. While the network welcomed the opportunity to encourage a diverse range of applicants to apply for the role, co-founder Sarah Amani said people of BME background should have been involved from the outset.

Chief clinical information officer for health and care, Simon Eccles, said the ad will be reworked “helped by good advice, to ensure we are properly inclusive, as we originally intended”.