The must-read stories and debate in health policy and leadership.

Back in summer 2020, then health secretary Matt Hancock tasked Baroness Camilla Cavendish with carrying out a review into social care. In particular, the crossbench peer, journalist and former David Cameron adviser was asked “to make recommendations for social care reform and integration with health in the wake of the covid-19 pandemic”.

Shortly after the review was commissioned, there were rumblings it could lead to the NHS taking over social care. Indeed, the final report says, “on paper, this would join up the care continuum”.

But this idea is quickly branded “a mistake”. Among the scathing reasons given are that the health service is “hierarchical, centralised and not person-centred” and “still struggling to join up primary and secondary care”. By contrast, the document calls social care “more innovative, more responsive, and human”.

Harsh words but, according to some HSJ commenters, also fair. One anonymous acute CEO wrote: “While the NHS [is] full of very human and humane people doing their very best for patients, the system itself is hierarchical, dictatorial and remains ruthlessly target focused… Let’s get our own house in order, using the opportunities ICSs offer, before unleashing NHSE on social care.”

Governors under fire after ‘bullying’ peers

Some governors at the Queen Victoria Hospital Foundation Trust in West Sussex acted in an “unprofessional manner” which did not appear to conform to the Nolan Principles, according to an independent review. 

Relationships between the board and the governors broke down, with ‘a cycle of mistrust’ between the two, said the report.

Some governors’ actions placed ‘an additional burden on staff at a time of unprecedented challenge for the NHS’.

The review found the governors had acted outside the parameters of their role, including calling for a pause to any work on a proposed merger and passing a vote of no confidence in the chief executive. Some governors and board members felt bullied by other governors, it added.

But it concluded that moves towards a merger of Queen Victoria Hospital FT, in West Sussex, and University Hospitals Sussex FT, a large acute FT, had “not been an exercise in winning hearts and minds”, and lack of clinical input had led to discontent among consultants.

Also on today

In a comment piece, Sir Chris Ham says that partnership with local authorities and meaningful engagement with people and communities are the best way of ICSs earning a mandate to push back. And in London Eye, Ben Clover asks what the new capital funding, aimed at helping with the elective care backlog, can really achieve.