Daily Insight: (Big) heads you lose

What is it with NHS England and egotism?

A job advert, published last month, said it wants a chair-in-common with a “low ego and high EQ [emotional intelligence]” to lead a group of trusts with a combined income of more than £3bn.

The trusts – Chelsea and Westminster Hospital Foundation Trust, Imperial College Healthcare Trust, London North West University Healthcare FT and The Hillingdon Hospitals FT – have all agreed to be led by a single chair.

This means the successful candidate, whoever they are, would lead the largest group of trusts in the NHS. Interesting, but also daunting.

It added: “An outstanding communicator and relationship builder, the incoming chair will bring experience leading and transforming organisations to deliver a step change in performance.”

Last September, NHSE sought a “strong”, substantive chief operating officer who “shares power and risk and suspends ego”.

Something about doing certain things with your ego appears to be a prerequisite for some of the toughest jobs in the health service.

After all, NHSE promised that: “Delivering the role of NHS chief operating officer for our NHS will indeed truly be a career-defining experience.”

What you and the NHS determine is “career-defining” might differ, though.

Mayflower foundering

Access to GPs has been a hot topic in recent months, but residents in one city would be justified in having more than the usual fears about seeing their doctor.

Up to 40,000 people in Plymouth could be affected by a potential suspension of services at a large-scale GP group in the city unless improvements are made quickly.

During August and September, the Care Quality Commission twice warned Mayflower Medical Group it was putting patients at risk after inspectors found a range of failings.

The group runs six practices in the city, and it covers a patient population which lives in an area of high deprivation.

This makes having reliable access to healthcare all the more important, but – following their two inspections – the CQC has sent a “letter of intent” to the group requesting immediate improvements.

The next step after such a letter would be to suspend the provider’s licence, which would halt all services at the group.

Naturally, Devon’s commissioners are growing increasingly concerned, and their scrutiny and oversight of the group is being ramped up.

Halting services at the group, which covers one sixth of Plymouth’s population, could have drastic consequences for the city’s primary care capacity, and the patients affected.

Let’s hope it doesn’t come to that.

Grass is greener on this side

With the list of integrated care system chief executives nearing completion, our editor asks why almost none of the acute sector’s leading lights has made the leap.

Alastair McLellan declares it an effective vote of little confidence in the permanence and power of the new order and goes on to offer reasons why, with one being that “becoming an ICS chief executive is not seen as a good career move for an acute trust chief executive”.

He notes a widespread belief that running a trust is a more fulfilling and “proper” job, and deep scepticism about the value of commissioning within the acute sector.

“There also remains widespread confusion about what ICSs’ real powers and role will be, and how much they will be dogged by labyrinthine governance.”

These are pragmatic reasons, he observes, and the big names of the acute sector would have moved if they thought that power was really shifting.

Alastair compares the situation to the announcement of sustainability and transformation plans’ leaders five years ago.

Back then, it was an impressive list that included Sheffield Teaching Hospitals FT’s chief Sir Andrew Cash, Frimley’s Sir Andrew Morris, Royal Free’s Sir David Sloman, Ipswich’s Nick Hulme, Surrey and Sussex’s Michael Wilson, Bristol’s Robert Woolley, and Coventry and Warwickshire’s Andy Hardy. There were also two up and coming female trust chief executives, Amanda Pritchard and Pauline Phillip.