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

Croydon: much improved and also the worst

For a long time Croydon has struggled with its image. This is particularly true of the health services that serve London’s most populous borough.

There was a concerted management effort to not refer to the hospital by the name it traded under most of its life, The Mayday, in light of its poor reputation locally and further afield.

A large accounting scandal at the beginning of the decade in the primary care trust was also bad for the image of Croydon’s health services and the acute trust often figured in the bottom 10 of national tables on finance and performance.

Happily the trust’s performance is widely thought to have improved (much of the credit for this goes to former chief executive John Goulston). Although both trust and commissioner were in financial special measures as recently as 2016, the organisation was well regarded enough to be considered for an interesting step forward in integration: a joint chief executive across the CCG and the trust.

The trust took on the running of community services once the PCT wound down and has trumpeted its integration with the local council and mental health services.

So it is a bit of a surprise to see it come out of the national inpatient survey so badly.

It was the only organisation nationally to get a “much worse than expected” rating from patients, a significant fall on the previous year.

The two factors were a perceived lack of nurses and difficulties in discharging patients. Pretty much everywhere has problems recruiting nurses (Croydon has 200 band five vacancies), but integration was supposed to be the trust’s USP.

It is difficult to see what happened here unless the lack of nurses was what caused the delays in discharge, and if that is the case the trust has not said so.

A chief operating officer once made the point to Daily Insight that the NHS was good at specialist care, it was the basics that it fell down on. This will only get worse as the workforce crisis continues to go unmitigated. There will surely soon be a case, if there hasn’t been already, of someone dying from a fall whilst unattended after complicated, world-leading specialist treatment.

Now chair can help choose chief

An appointment can now be made to one of the most important jobs in the provider sector, after a new chair was appointed for the two acute trusts in Liverpool.

Sue Musson will chair the joint board created between Aintree University Hospital Foundation Trust and the Royal Liverpool and Broadgreen University Hospitals Trust, which are due to merge in October.

Currently, chair of Lancashire Teaching Hospitals, Ms Musson’s first job will be helping choose the chief executive for the new £900m turnover organisation.

Given the multiple fronts on which Aintree and The Royal are struggling or have to make immediate progress, this will be one of the toughest jobs in the provider sector.

Including Steve Warburton, Aintree’s incumbent chief executive, there are thought to be several candidates from other trusts in the North West, as well as a few others from outside the region.