Today’s must read stories and debate

CEOs take on the CQC

After it was rated “inadequate” by the CQC, kidney transplant surgeons at Addenbrooke’s were asked by their patients if the procedure they were having (at a recognised centre of excellence for that work) was safe.

This point of detail in the King’s Fund’s new report, The Chief Executive’s Tale, shows both the importance and the unfairness of “regulator-max”, the souped up hospital inspection regime Jeremy Hunt brought in.

The snippet was cited by former Addenbrooke’s boss Keith McNeil as an example of “the damage [the CQC] can do”, and the reputation shredding that an “inadequate” rating can give.

On the one hand, it shows how unfair it can be to give the intricate, discrete work of a teaching hospital a one word description – ideal for headline writers but unhelpful at the specific levels patients encounter services at.

On the other hand, trusts are accountable to the public – if it takes the transplant team having to hear an echoed complaint about poor nurse staffing then maybe that’s a good thing. Sadly, a complaint from surgeons will have more impact than a complaint from a relative.

The “inadequate” of Addenbrooke’s and subsequent departure of Dr McNeil was a big moment in recent NHS history, with two other chief executives in the report rueing the reputational damage and the sense that the leadership had been hung out to dry.

The report made a point of not being too gloomy, but a telling fact revealed by author Nick Timmins was that several retired CEOs felt the experience was still too raw to talk about.

Another interpretation is that a vengeful hand from higher up the system might make trouble for them somehow.

‘Incoherent’ DH given dressing down

The Department of Health took heat from the Commons public accounts committee on Wednesday over its flagship seven day services policy.

The committee said the DH has made “no coherent attempt” to assess the impact of seven day NHS on the clinical workforce. Meanwhile negotiations continue between the BMA and government over the junior doctors’ contract – which the government insists will support a seven day service.

The MPs claimed the department was unable to provide an indication of the size of the workforce required to implement seven day services, even approximately.

The MPs also raised concerns that funding for seven day services may not be sufficient and said there had been no attempt to separately cost the policy against the £10bn additional funding promised by the government in the 2015 spending review.

Committee chair Meg Hillier was scathing: “Taxpayers are being asked to accept uncosted plans for a seven day NHS – plans which therefore present a further serious risk to public money.

“It beggars belief that such a major policy should be advanced with so flimsy a notion of how it will be funded – namely from money earmarked to cover all additional spending in the NHS to the end of the decade.”

The DH was bullish in its response: “This report doesn’t properly take account of the dramatic workforce increases we have delivered, or our clear plans to increase capacity in the future in order to deliver a safer, seven day NHS…

“By March next year, we will provide a quarter of the population with seven day care.”