The must read stories and debate from Wednesday

Ethical finance

When it comes to NHS finances, the ethics issue is not going away.

Many finance directors will sympathise with Rick Tazzini, formerly of Basildon and Thurrock University Hospitals FT, who warned his trust not to accept a savings target that he felt was unachievable and would jeopardise patient safety if agreed.

Leaked papers seen by HSJ show that the trust rejected his advice and accepted the control total anyway. He appears to have left the organisation shortly afterwards.

HSJ has published numerous stories on the increasing pressures faced by local leaders when it comes to financial performance over the last 18 months – and highlighted several examples of trusts setting highly speculative plans.

It’s clear there’s a range of views across the system, and some finance directors feel the ethics issue is sometimes used as an excuse not to take the tough decisions.

But when a professional body carrying the authority of the Chartered Institute of Public Finance and Accountancy starts raising concerns on the issue, it is worth taking seriously.

Its chief executive Rob Whiteman told us: “We cannot, on the one hand, criticise companies like Tesco for misrepresenting underlying financial performance, and on the other hand accept that part of the state is risking avoiding bad news in the public domain to the point of ethical concern for senior managers – and, more importantly, failing to come clean on pressures reduces the likelihood of taking the difficult actions that are needed to balance the books.”

Kent’s new broom

The chief executive of Dartford and Gravesham Trust is to take on the leadership of one of the NHS’s most challenged providers.

Susan Acott will take over as interim chief executive at East Kent Hospitals University FT, which has recently had the worst accident and emergency performance in England.

Previous chief executive Matthew Kershaw resigned last month after the trust reported months of very poor performance against the A&E four hour target.

Ms Acott will work alongside former Royal College of Nursing chief executive Peter Carter, who was appointed as interim chair earlier this month. He will succeed Nikki Cole on 17 October. Ms Acott will join the trust on 16 October and stay until 31 March 2018.

She has been chief executive at Dartford and Gravesham since 2010. Her role at that trust will be filled by Gerard Sammon, director of strategy and planning, while she is at East Kent.

She has guided the organisation through a difficult period. A planned merger with Medway FT was abandoned and the trust had to take a different direction, taking on some services at Queen Mary’s Hospital in Sidcup and working more closely with Guy’s and St Thomas’s FT.

Ms Acott takes over at a fraught time for East Kent. Consultation on significant acute service changes is expected to launch early next year amid fears that Kent and Canterbury Hospital could lose services. The Canterbury constituency was unexpectedly won by Labour in June’s election, adding a political dimension to rows over reconfiguration.