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Uncovering the numbers

When a much anticipated NHS report fails to emerge into the public domain, HSJ will do its utmost to step into the breach.

Last week the BBC reported how regulators has been prevented from publishing the year-end financial performance report for NHS trusts – but our research has revealed the numbers.

HSJ’s research suggests the sector’s combined deficit for 2016-17 could be as high as £770m and around 100 out of 235 providers ended the year in the red, with dozens more only avoiding a deficit through one-off savings or technical accounting measures.

The final reported figure is likely to be lower – between £750m and £700m – due to further one-off adjustments that may not have been finalised before trusts reported their numbers to regulators.

NHS Providers “hailed” what it sees as a strong performance by trusts, given the rising demand and cost pressures.

But the figures do flatter the real underlying position, which is likely to be significantly worse than this.

Mistakes in maternity care

Safety fears around maternity services have made a lot of headlines in recent months and after a number of worrying coroner’s reports, an HSJ investigation aimed to understand at least one possible factor in why babies are dying in NHS care.

Our enquiries have established that there are widespread mistakes in the interpretation of foetal heart rates, which can be a warning sign to babies being in distress during birth.

We obtained new data from NHS Resolution showing failures to act on abnormal foetal heart rates has been the primary cause of clinical negligence claims in recent years, with hundreds of cases costing the NHS almost £500m.

As part of the investigation, we looked at the training for students and staff, and coroners have warned they don’t think NHS trusts are doing enough to ensure midwives can properly understand heart rate readings.

More worryingly, HSJ found multiple reports in which the issue was highlighted as a major cause of negligence and death.

Experts from the Royal College of Obstetricians and Gynaecologists said trusts must focus on multidisciplinary training with an emphasis on continual learning.

We also wanted to highlight some solutions from Barking, Havering and Redbridge University Hospitals Trust, where staff have achieved a dramatic turnaround, reducing heart rate errors from 75 per cent of all maternity incidents to zero during the past 11 months.