The biggest stories and talking points from Wednesday

NMC held to account

A damning report by the Professional Standards Authority, published on Wednesday, puts the resignation of Nursing and Midwifery Council chief executive Jackie Smith earlier this week in new light.

The investigation by the PSA into the NMC’s handling of concerns about midwives at Morecambe Bay and how it dealt with the bereaved families delivers a devastating verdict on the regulator.

It describes the NMC ignoring real safety concerns raised with it by Cumbria Police for more than two years. These delays allowed midwives to continue working who were involved in more incidents of poor care including a death.

The NMC lost key evidence and was not open about this and even appears to have misled the health secretary in a letter saying it had carefully considered evidence, which in fact it had lost. Families were ignored, investigations were flawed, record keeping was poor. The culture of the NMC and the confidence the public can have in the regulator has been seriously undermined.

The PSA rightly suggests the NMC needs to focus on changing its culture to really appreciate its role in dealing with families’ concerns.

Lagging on locums

Attempts to reduce locum medical spending in London are being hampered by concerns over staffing shortages, with one major trust delaying adoption of new lower pay rates.

HSJ has been told trusts across London were due to align their spending caps on bank locum pay rates by April, however Barts Health Trust has said it is still negotiating the rates because of “acute” staffing shortages.

The trust runs five hospitals across London including the Royal London major trauma centre and is the biggest trust in the capital.

The new rates of pay were developed by the Pan London Bank and Agency Steering Group, which is made up of trusts across the city.

They were introduced by trusts for agency locums in October and were supposed to be rolled out across the capital for medical bank staff from April 2018.

Medical locum spending has been a priority for NHS Improvement in recent years. It introduced a nationwide cap on all agency spending, including nursing and medical agency workers, in November 2015.

The regulator has expressed concern that locum spending has not fallen to the same degree as on nursing and other agency staff roles, and continues to see a higher level of breaches.

However, Stephen Mhiribidi, legal head of locum advocacy group the Independent Health Professionals Association, said locums have taken “massive rate cuts”, which is affecting their financial and mental wellbeing.