The must read stories and debate in health

Clearing up the consolidation plan

Another month, another missive – NHS Improvement has sent a further message to trust chief executives, outlining which back-office services they should prioritise in consolidation plans.

The latest email follows letters sent in June and July instructing trusts to draw up plans to squeeze savings out of back office, pathology and “unsustainable” elective care services.

The measures are part of an urgent attempt to bring the provider sector deficit down to a manageable £250m this year.

What exactly constitutes the “back-office” is not always clear, so NHS Improvement has set out the areas it wants trusts to target, and there’s quite a lot them.

Financial accounts, commercial teams, learning and development, temporary/staff bank teams, communications, estates and facilities and legal services all appear in the list.

Changing the back-office is viewed as far less politically explosive than reconfiguring “frontline” clinical services – which is precisely why NHS Improvement has identified it for a big in-year savings push.

Nevertheless, consolidation – a euphemistic term for the creation of shared services or outsourcing – still has the potential to provoke controversy. NHSI will have to closely assess the plans received from trusts to ensure they’re sufficiently robust, and providers will have to tread carefully as they restructure these services.

The thing about the “back-office” is that it underpins the working lives of everyone employed in the NHS.

People don’t give it much thought when things are ticking along effectively, but it’s a very different story when someone messes up the payroll or if you can’t log into your email.

Inquests denied

Discrepancies in official data examined by HSJ suggest hundreds of patients who died while being detained under the Mental Health Act could have been denied inquests.

By law, all deaths in state detention should be reported to the CQC and examined by a coroner.

However, inconsistencies between official data on deaths reported to coroners in England and Wales and notifications sent to health regulators by NHS trusts suggest coroners may not have conducted inquests into every death.

Between 2011 and 2014, 373 deaths of people detained under the act were reported to coroners in England and Wales, according to data held by the Ministry of Justice.

In contrast, data compiled over the same period by the CQC and the Health Inspectorate for Wales shows a total 1,115 deaths – 742 more than was reported to coroners.

The Department of Health said all deaths in detention should be properly investigated. While some differences in the data could be explained by different methods of recording, the DH admitted there was a risk some patients and families had been denied inquests.

Feel the Burnham

Andy Burnham has been nominated as Labour’s candidate to be the first elected mayor of Greater Manchester, and will be considered the favourite to become the region’s first elected mayor.

While the mayor will not have direct control over the region’s devolved £6bn health and social care budget, they are expected to be an influential voice in shaping public policy in the region.

As health secretary and in the shadow cabinet, Mr Burnham consistently spoke about the need to improve social care, and better integrate it with the NHS. In opposition he developed a policy of “whole person care”, aimed at linking the NHS and care systems, while more recently he said he will retain nursing bursaries for students who agree to work in Greater Manchester for five years after qualifying.