The biggest stories and debate in the NHS

Nicholson returns

Former NHS England chief Sir David Nicholson has been appointed interim chair of a troubled West Midlands hospital trust, after the previous chair left after less than two years.

Sir David will start the role at Worcestershire Acute Hospitals Trust on Monday.

The trust is rated inadequate, is in quality special measures and has history of governance issues. However, a Care Quality Commission report in January also highlighted leadership improvements since chief executive Michelle McKay’s arrival in 2017.

Financially, the trust has also struggled, with a forecast outturn for 2017-18 of a £56.3m deficit – £26.3m behind plan and equating to 14 per cent of turnover.

Ms McKay said Sir David’s “knowledge and understanding of the challenges we face in this trust and across the wider health and care system will, I am sure, be enormously helpful to our efforts to secure safe, high quality hospital services for the people of Worcestershire, as well as the work we are doing to move to a position of sustainable financial balance”.

Keep your head

NHS Improvement chair Baroness Harding has said a priority for her and chief executive Ian Dalton will be putting more focus on the development and career paths of senior leaders, and on supporting them.

Asked whether she could be confident that trusts currently without substantive chief executives – including several of the biggest providers – would be able to make good appointments, she said she could not because NHSI had not tracked would be candidates elsewhere in the service.

She said: “One of the questions I asked when I joined [NHSI] was: where is the talent map?” This would be a list of the “dozen or half dozen or so leaders who are ready for a move”, she said. “Any of the large organisations I’ve worked for would have been able to give me that information.”

She said she was concerned too many senior NHS leaders lost their job after taking on difficult roles.

Baroness Harding said in other industries “the only way you get promoted is if you do some horrible jobs. That’s the way of earning your stripes. In the NHS the opposite has been true: if you do the hard jobs you are likely to be decapitated.”

She said in some cases senior managers who had struggled had in the past been “decapitated privately then a year later they pop up somewhere else”.