The must read stories and talking points from Wednesday

Cornwall ACS beached?

The confusion and suspicion from the general public around the term “accountable care” has been perfectly illustrated by recent events in one struggling health economy.

This month, after conducting an inquiry into accountable care systems, Cornwall Council issued a statement in which it rejected plans for an ACS in the county.

The statement was reported in the local paper as a decision to “abandon plans to privatise the NHS”, and led to a certain amount of head scratching among puzzled NHS leaders in the county.

However, it appears that the council’s statement was aimed at disassociating itself from the term “accountable care” rather than the plan currently pursued by Cornish health and social care chiefs.

This followed a politically led local campaign which feared Cornwall was travelling towards an American style healthcare system.

However, the actual plan is rather different and focuses on the council and clinical commissioning group working closer together to develop an “integrated strategic commissioner”.

Iain Chorlton, chair of the CCG, told HSJ the council’s statement would not change those plans.

Precisely what the strategic commissioner will look like in practice remains to be seen, though the plans make vague references to the potential for single contracts and VAT advantages – two issues that are doubtlessly being explored elsewhere too.

While work towards this appears to be more slow than fast, Cornwall can’t afford to maintain the status quo for long given the precarious financial position of its CCG, which is forecasting a cumulative deficit of £91m by April.

Hopefully, the new commissioning function, when it evolves, will be met with less suspicion thanks to a more politically savvy prefix.

Mixed results in staff survey

More than one in five NHS England staff said they had been bullied, harassed or abused in the past year in its latest staff survey, which also shows improvements in several areas.

The overall scores of the NHS England Census 2017 survey, distributed internally in recent weeks, have been leaked to HSJ.

Several scores were improved on the 2016 NHS England staff survey, for example 62 per cent said they would recommend NHS England as a place to work – up from 58 per cent in the previous survey.

Twenty two per cent said they had been bullied, harassed or abused at least once in the past 12 months – down from 24 per cent in the 2016 survey, according to the result documents for 2017 and 2016 seen by HSJ.

It is lower than the 27 per cent who reported bullying or harassment in response to a similar question in the 2017 survey of staff in the NHS locally.

However, asked who they were bullied or harassed by, 28 per cent of NHS England staff who answered said their direct supervisor or line manager, 24 per cent another manager within their own team, and 15 per cent a manager from another team.

In the 2017 NHS staff survey, published last week, just 12 per cent reported experiencing bullying or harassment by managers at least once.

The NHS England 2017 survey found 60 per cent said they felt able to report bullying and harassment – up from 58 per cent in the 2016 figures.