The must read stories and debate in health

Leading from the front

Calls from MPs for an “urgent explanation” as to why the senior leaders of a crisis hit trust went on holiday during “a really difficult period” has generated an interesting debate.

The battle lines are always swiftly drawn on issues like this. Some will always decry the absent leaders and call for their heads. Others will always defend the executives’ right to a break and question the motives of the accusers.

Both sides are on show in the comments section of our latest story about East of England Ambulance Service Trust, which has been rocked after at least 40 patients were allegedly harmed or died due to ambulance delays.

Everyone deserves a holiday – the chief executive included. NHS managers of all ranks work hard and often their efforts go underappreciated by members of the public and politicians.

Many NHS directors of all levels will have found themselves technically “on holiday” over the festive period but in reality they were glued to their phones and laptops, making significant decisions from their virtual office.

Equally, a lot of chief executives would have found themselves in the hospital on Christmas Day. They would not have come in if they didn’t think they could achieve something in person that they could not have at home.

A show of solidarity with staff from the boss on days when the rest of country is taking time out – or, when the organisation is under significant stress – is meaningful and helps instil a sense of organisational togetherness and confidence. It shows they are willing to go out of their way to back their staff.

The specifics of what happened over the festive period at the East of England Ambulance are still emerging.

But what we can conclude so far is that a significant number of patients were most likely harmed or died because of delayed ambulances, and the trust was forced to declare “REAP 4” status – the highest level of operational risk.

The trust insisted it had sufficient leadership in place throughout the period and “a minimum of three executive directors” were working at any given time.

But this period could well be the most stressful the trust has ever experienced. The accountability for how the organisation responded during that time will always come back to the board.

Sometimes being the boss means not only leading, but being seen to be leading from the front. Perceptions are important.

The questions raised by MPs are sensible and deserve honest answers.