The must read stories and talking points in the NHS

Morality tale

In her first interview with HSJ, NHS Improvement chair Baroness Dido Harding has made a clear statement of intent about how the regulator will act when it comes to NHS managers who “cross a moral line”.

In short, the Conservative peer was clear that for those managers who fall below the standard they will not work in the NHS again. Interestingly, she said to deliver this would require “a firmer fit and proper person test”. She also referenced the work being undertaken by the Care Quality Commission and Department of Health and Soical Care to review the regulations following the report by Bill Kirkup into failings at Liverpool Community Health Trust.

But readers may welcome Baroness Harding’s nuanced approach to leaders that fail. She rightly recognised that failing leaders are not always bad people, some have simply been promoted into senior roles without the necessary training and coaching to support them. She intends to do more on the NHS management of talent. She told HSJ: “If I am really honest, I am quite shocked by the absence of the sort of talent management and performance management at the senior levels in the NHS compared to other organisations.”

Her comments on the “moral line” inevitably prompt questions as to who draws it and where.

NHS Improvement has not covered itself in glory dealing with disgraced leaders from Liverpool Community Health or Wirral University Teaching Hospital Foundation Trust, and it is not clear who exactly approved what when they were offered new jobs.

As well as a stronger fit and proper person test, Baroness Harding will need to ensure the judgements of NHSI staff on where to draw the moral line are in tune with her own view.

Cancelled cancer operations

More than 500 cancer operations were cancelled by hospital trusts in England due to winter pressures.

HSJ received information from 81 acute NHS trusts, of which 43 said they had cancelled at least one operation between December and February.

Across those 43 trusts, 530 operations were cancelled. This included some diagnostic procedures such as biopsy.

NHS officials had recommended cancelling most elective hospital care during January and February, while pressures were most severe, but stated that “cancer operations and time-critical procedures should go ahead as planned”.

The largest numbers of cancellations were at some of England’s largest hospital trusts.

Leeds Teaching Hospitals reported 109 cancer cancellations, which it said was out of around 1,400 cancer procedures it would have carried out over the three months. It said it was “very sorry” but “had no other option… during a period of extreme pressure”.

University Hospitals of Leicester reported 88 cancellations, and its main commissioner has said that 32 cancer operations were cancelled over a five-day period as “bed occupancy within all three UHL sites prevented patients stepping down from the [intensive care unit]”.

University Hospitals Bristol reported 66 cancer cancellations, University Hospitals Birmingham reported 45 and Lancashire Teaching Hospitals 29.

Numbers of cancer cancellations for previous years are not available but experts, and the trusts with the most cancellations, said the figures shared with HSJ for 2017-18 were unacceptable.