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It’s always important for a leader to “hold the room” and bring key elements in their organisation with them. However, there are always hecklers who oppose change – and they can be vocal.
Keir Starmer found that out in his speech to the Labour conference this week. And so has Steve Jenkin, chief executive of the Queen Victoria Hospital Foundation Trust, coincidentally just up the road from the Labour conference in Brighton.
Consultants at the trust – which is currently undertaking a full business case on a proposed merger with the University Hospitals Sussex FT – have passed a motion of no confidence in Mr Jenkin and asked the board to do the same. To add to his problems, the incoming interim chair – former RCN chief executive Peter Carter – has had to withdraw for health reasons.
Campaigners for the QVH to remain “independent” may seem quixotic – it has massive financial issues and, at the very least, needs to work closely with UHS to ensure complex patients get the right care – but consultants are concerned about what would happen to the very specialist work the trust does if it is absorbed by its larger neighbour. They point to other specialist work – such as neurosurgery – which has struggled within the larger trust.
And ultimately if consultants feel their specialty is being downgraded or they are not getting access to the facilities they need – such as theatre time – they could vote with their feet and move elsewhere. Just like Mr Starmer, Mr Jenkin may need to come up with a solution which keeps as many of his organisation in the room as possible.
NHS England has eased up slightly on two of its key targets and expectations for NHS trusts over the winter.
Planning guidance for the second half of 2021-22, issued yesterday, said providers will receive money from the ERF if they carry out more than 89 per cent of their pre-pandemic activity levels based on “completed referral to treatment (RTT) pathway activity” — also known as a “clock stop”.
The threshold for the past three months has been 95 per cent of all pre-covid cost-weighted activity.
Secondly, the baseline efficiency expectations for the rest of the year are not as tough as feared.
NHSE has applied a 0.82 per cent general efficiency requirement to trusts’ block payments, which is less than the 1.5 per cent baseline which had previously been suggested.
Most trusts will still have to deliver additional efficiencies on top of that baseline, of course, to offset overspending against their nominal financial envelopes (making the average efficiency expectation around 2 per cent). But it’s still less tough, and therefore less controversial, than expected.