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

It is unusual to see an interim chief executive appointed for as long as 18 months, as has happened at Medway Foundation Trust. That suggests that recruitment for the permanent role may be delayed to give the powers that be a chance to think about the trust’s future — or that the interim position is really a dry run for someone who will then be a shoo in for the job.

It’s not clear what the plans will be for George Findlay when he takes over at Medway next month but he will be tackling a trust with a long history of struggling to meet national targets and provide consistently safe and high quality care for patients. A few years ago, it looked as if the trust under Lesley Dywer was beginning to escape its history, with an improved Care Quality Commission rating but even Ms Dwyer found it hard to push forward further improvements.

When she returned to Australia, HR director James Devine took over but the covid pandemic — particularly in the last six months — has hit the trust hard and he has decided to move on.

Enter Dr Findlay, who is currently deputy chief executive of the recently-formed University Hospitals Sussex Foundation Trust. He has had experience of helping to turn round Brighton and Sussex University Hospitals Trust so Medway’s challenges won’t be unfamiliar to him. But only time will tell if he has the magic ingredient to improve the trust long-term.

Risky culture

University Hospitals Birmingham Foundation Trust has featured in HSJ a few times recently over issues linked to poor culture. Readers may remember a story during the height of the pandemic in which a senior director accused consultants of dodging intensive care unit shifts.

Now, a leaked report has revealed deep-rooted behavioural and relationship problems across the trust’s neurosurgery department. The report, written by the Royal College of Surgeons, warned poor team working and inter-relational problems between consultants could compromise patient care.

Reviewers noted how little consultants mentioned patient care during their interviews and suggested patients came second to their personal and professional difficulties.

The report also hinted at wider issues across the trust’s surgical workforce and noted concerns over the treatment of medical trainees, which were said to be ongoing for several years.

However, even more concerning was the use of Datix incidents and quality meetings by some to “get back at colleagues”. A culture in which fear over mistakes pervades is a common theme in many NHS scandals.

However, the report, which was sent to the trust in May 2020, did note some improvements. Let’s hope the pandemic has sped these up rather than hampered them.