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


Norfolk Community Health and Care Trust can this week bask in the universal sunshine and the glory of becoming the first NHS community provider to secure an outstanding rating from the Care Quality Commission.

The CQC praised the trust’s “stable, cohesive, passionate executive team” which had a “clear strategic vision and commitment to staff engagement”.

The trust, with under 80 beds and a turnover of around £130m, is further proof that back in vogue mega mergers are not the only way (if, indeed, the way at all) to secure excellent care and strategic vision.

Chief executive Josie Spencer must also be feeling the sun is shining for her in particular. The registered nurse only joined the high performing trust this month from neighbouring mental health provider Norfolk and Suffolk Foundation Trust, which has long been rated inadequate.

Ms Spencer will no doubt not be resting on her laurels. Getting to the top is tough, but staying there is even tougher.

Gloom time

Ramsay Health Care UK is one of the biggest private providers of NHS funded care and their recent stock market notification of financial difficulties is significant.

The Australian owned firm does a lot of the more basic elective work, as part of an overall independent sector contribution of 7 per cent of the total.

With the total elective waiting list topping 4.1 million you might expect it to be a boom time for private operators, both in direct referrals from commissioners, outsourcing from NHS providers and patient choice through the choose and book system.

But Ramsay says that commissioner run demand management schemes (screening out and delaying procedures) had contributed to a gloomy trading position that it expected to endure in the “medium term”.

The independent sector has come under significant attack from the CQC and Jeremy Hunt of late over quality issues.

While it has the capacity to take significant amounts of NHS work off the waiting lists, managers have always done their best to obscure just how much is being spent with the private sector in this way, presumably fearful of the headlines if a large slug of the promised spending increase went to often foreign owned private hospital companies.

Workforce gaps could undermine cancer pledge

The government’s aim to improve cancer care with its latest funding boost could easily be undermined by workforce shortages in the coming years, judging by new data from the Royal College of Radiologists.

Analysis by the college predicts a shortfall of 250 full time consultant clinical oncologists by 2022, which would threaten the ambition for English patients to have the best cancer outcomes in Europe.

The new data, taken from the college’s workforce census report, reveals that experienced clinical oncologists are leaving the NHS earlier, and an increasing number are working less than full time.

The college called on the government to fund more training places to ease the expected workforce shortages in this specialty, so treatment can keep up with cancer rates.