HSJ’s essential round-up of the day’s must read stories

The community hospital dilemma

HSJ has published the first ever analysis of safe staffing figures for community hospital wards.

The data does not bode well for these services, with nearly a third of trusts with a community hospital ward failing to meet their own nurse targets for the past two years.

Our analysis shows these trusts consistently failed to hit the level of planned nurses during the day on their wards and data suggests the situation is getting worse.

But beyond the data the story is not so clear cut. Many of the trust’s that responded to HSJ said they have ambitious plans, which is why they appear to be failing in comparison to other trusts who set the bar much lower.

NHS Improvement, which published the data, also warned it does not reflect actual activity and the acuity of patients on the wards.

This presents quite a dilemma for those looking to decipher whether their local community hospital is understaffed or not.

One explanation is that trust’s may not be planning effectively for these wards, which are very different in nature from an acute ward.

If trusts are failing to meet their target it could not only show an issue with staff numbers, but also whether trusts are planning as well as they could be.

Then there is the use of other roles. A number of trusts told HSJ they use a higher number of healthcare assistants, occupational therapists and physios due to the low acuity of the patients on community wards and their need for more staff to have rehabilitation skills.

According to the data, the use of unregistered staff during the day has almost doubled on these wards over two years, which could reflect an increasing dependence on HCAs in community hospitals as opposed to nurses.

Nonetheless, the figures to lend themselves to the worsening picture of an NHS workforce crisis. It has been widely reported that the NHS is in trouble when it comes to nurse numbers and as one healthcare leader told us: there is no reason to think this shortage is not affecting community hospitals as well.

Rationing rethink

Commissioners have abandoned plans to restrict access to hearing aids after a foundation trust warned they could be breaching their legal duties.

Milton Keynes Clinical Commissioning Group will no longer proceed with controversial proposals to restrict hearing aids from two to one and stop issuing hearing aids to people with mild hearing loss.

HSJ revealed earlier this month that Central and North West London Foundation Trust had warned the CCG the “incredibly damaging” proposals ignored medical evidence and conflicted with NHS England’s hearing loss strategy.

The CCG has now said it will not go ahead with its plan following eight weeks of consultation.

Despite jettisoning the proposals for adult hearing services, the CCG will go ahead with its proposals to stop prescribing gluten-free food and over the counter medication. ariatric surgery including gastric band, gastric bypass and sleeve gastrectomy will be classed as “not routinely funded” from 1 July, despite calls for a rethink by the Royal College of Surgeons.