The must read stories and debate from Tuesday

No room for ‘unrealistic’ A&E plans

NHS Improvement’s chief executive has warned that new money allocated to the NHS for 2018-19 will not help patients unless local leaders get their emergency activity forecasts right.

In an interview with HSJ – his first since taking over at NHSI in December – Mr Dalton criticised past emergency care planning for being “unrealistic”, and called on leaders to produce forecasts that reflect the “local clinical reality”, to enable trusts to build capacity during the year. The alternative just leads to extra costs when additional unplanned capacity is bought in a hurry.

Some context: last year the NHS planned for 1.2 per cent annual growth in non-elective admissions in 2017-18. At month eight, the real figure was 3.1 per cent.

Has this resulted in worse care due to capacity constraints in hospitals? Mr Dalton didn’t explicitly say so but the implication is there: “Any new money won’t make it to patients unless we collectively plan and deliver the right level of capacity… we’ve seen a significant increase in non-elective demand that has driven capacity pressures at hospitals – not least in the last few weeks.

“This year, it is essential that we agree what we’re planning for, to build capacity and get patients cared for… the system doesn’t have the headroom for unrealistic planning.”

Readers’ comments note Mr Dalton’s approach makes a change from the kinds of calls local leaders have sometimes faced to be “ambitious” in their efforts to contain emergency demand growth.

Francis five years on

On 6 February 2013, Sir Robert Francis QC published his landmark report into the Mid Staffordshire Foundation Trust care scandal.

His recommendations were the catalyst for major changes in how the NHS approaches issues around patient safety, organisational culture and the workforce.

In his latest expert briefing, Shaun Lintern looks at the impact of the Francis report over the last five years and what still needs to be done to prevent another Mid Staffs.