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NHS chiefs have been warning since last summer about the risk the British Medical Association’s rate card poses to elective recovery.

But there have been few examples of a trust publicly making an explicit link between its struggle to staff overtime shifts because of the rate card and subsequent failure to hit its elective targets – and placing a number on how many patients then added to the list because of the issue.

University Hospitals of Morecambe Bay Foundation Trust has done precisely this. In a board paper discussing its elective targets, it explained how a waiting list validation project had removed 940 patients from the waiting list but the “rate card issue” meant an additional 962 patients remained on the lists over a two-month period, instead of being treated.

Morecambe Bay is far from alone in its struggles on this matter. With little sign of a rapprochement between the BMA and NHS Employers, the matter remains an increasingly concerning challenge for system leaders.

An ‘impression of disproportionate deaths’ 

Essex mental health services are under scrutiny from an ongoing high-profile inquiry, which is looking into 2,000 deaths over two decades. Its scope has, however, been questioned by a chief executive of a trust at the heart of it.

Essex Partnership University FT’s Paul Scott said he was concerned the number of deaths being looked into was creating an “impression of disproportionate deaths” in Essex in a letter to the inquiry chair, seen by HSJ, as hundreds of these deaths were from natural or unknown causes, with only 500 unexpected. 

Mr Scott also suggested the inquiry increases its “capacity and expertise” to ensure it can deliver in its current form.

The inquiry’s chair, Geraldine Strathdee, has previously raised concerns over its future if it remains non-statutory, as this means staff are not compelled to give evidence. In an open letter, she revealed just 11 out of 14,000 current and former staff contacted had promised to attend evidence sessions. 

HSJ was told Ms Strathdee was in the process of responding to Mr Scott’s letter. An EPUT spokesperson said it believed “many more” staff had recently come forward. 

Also on hsj.co.uk today

An employment tribunal decision has revealed a “toxic and difficult working environment” at an East Kent Hospitals University FT maternity unit where staff were “shouted and sworn at over differences of professional opinion”. Meanwhile, this week’s London Eye takes a closer look at the potential future locations of south London’s children’s specialised cancer services.