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Passive aggressive neighbours
Not easy, running an academic health science centre.
These Labour-era creations are quietly influential in shaping the direction of the big teaching and research hospital institutions.
The interface of educating the specialists of the future, making new discoveries and actually treating patients is a tricky one. Managers have to be careful problems in one area don’t affect another.
King’s College Hospital Foundation Trust has been unfortunate in this regard. A PwC report into how it came to have a deficit three times larger than planned in 2017-18 also notes that Health Education England withdrew its radiology trainees from one department. HEE’s job is to ensure they get trained properly but this also meant it was hard to actually run the service – education issues hitting performance.
Now papers from the FT’s partner in the academic health science centre, Guy’s and St Thomas’ FT, reveal the AHSC’s plans for a haematology institute have not been supported by regulators because KCH is in financial special measures – performance issues hitting research.
How did the trust get into a deficit of more than £100m?
One of the factors was a significant increase in the spend on clinical staff, including a substantial chunk for increasing haematology staffing. Another was uncertainty over payments from commercial research firm Celgene – research hitting regulatory performance.
King’s had to write to MPs in Bromley – one of the London boroughs it serves – about delays for scans in haematology and two other services, so there is a fair case to increase staffing.
The haematology institute intends to centralise the work – worth £120m across south London – on one site at King’s. There seem to be issues, however, between KCH and its neighbour to the north.
Guy’s and St Thomas’ FT said it had formally written to KCH about “issues” with the haematology pathway – one they will eventually co-provide.
A few years ago, King’s Health Partners investigated whether a full merger between KCH and GSTT should go ahead.
It didn’t, and one of the interviewees – a clinical lead – told KHP the rivalries between departments at the two trusts could sometimes look like “landgrabs before the armistice”.
The author of the report said in his travels between the trusts he had seen “considerable” evidence of “passive aggressive behaviour”.
The latest evidence suggests there hasn’t been much improvement.
If you’ve been reading HSJ over the last few months, this week’s story on Shrewsbury and Telford Hospital Trust may not come as a big surprise.
Following a series of reports on the quality and safety of its services, which included three Care Quality Commission enforcement action notices, the trust is now set to be placed in “special measures”.
The only surprising thing about this is that NHS Improvement’s decision may have come before a recommendation from the CQC.
News about the regulator’s intentions to put SATH into special measures was broken by a local Conservative MP Lucy Allen yesterday, who had received a letter from the health and social care secretary Matt Hancock, informing her of the decision.
This letter came on the same day CQC chief executive Ted Baker sent a letter to NHSI recommending the trust get “extra support”.
Whichever way the decision on special measures came about, it has been welcomed by most who recognise a trust in need of all the support it can get.