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

Trusts are under too much pressure to cope with their waiting list backlogs to worry about inaccurate data, NHSE&I has argued in a system letter requesting permission to authorise checks on waiting list data across the country.

Via a series of patient tracking lists “diagnostics”, the aim is to ensure trusts are not hampered by poor data quality and waiting list inaccuracies, particularly those caused by the impacts of covid-19.

It also says that doing so will help identify pathways that can be removed from tracking lists; it insists the move is not meant to remove patients who should be waiting for treatment.

In any case, a data audit is arguably a prudent move in the knowledge that less than two years ago, one in four trusts nationally were discovered to have performance data quality issues. Validating the waiting lists seems therefore worthwhile but its motives should ideally focus on meeting demand and providing effective care, not (as the letter at least suggests) meeting performance targets.

The bigger picture

Care Quality Commission reports on services for people with learning disabilities and autism make grim reading far too often. The latest report on Cedar House, near Canterbury, is no exception. Prolonged restraint, dirty surroundings and a reliance on agency staff contributed to an “inadequate” rating for the facility, run by Huntercombe Group.

But who was to blame for what was undoubtedly a poor experience for some of the residents? The CQC was critical of senior managers, who were not regularly present on the wards.

But some of the problems point towards some more systemic issues. Delayed discharges and transfers meant that staff were coping with patients whose needs could not be met on the unit. One patient had been refused by five medium secure units and was awaiting assessment in a high secure setting – a pretty clear indication that a low secure environment wasn’t the right place for him. Another had waited over 10 years for a bed elsewhere.

Such long waits and inappropriate placements are likely to leave staff struggling to cope. No surprise then that seclusion, segregation and restraint end up being used – or that the CQC cracks down. But the solution may lie with commissioners, not providers.