A round-up of the day’s must read stories and debate

Change of direction on turnaround programme

A financial turnaround project where management consultants are sent to work with NHS trusts has been shelved by NHS Improvement.

The third wave of the financial improvement programme was due to start with up to 20 trusts in early 2018 but sources involved told HSJ an “in-house” team will now work with the most troubled providers instead.

The programme was introduced after controls on trusts’ consultancy spending were introduced in 2015, which meant expenditure over £50,000 needed to be approved by the regulator.

NHSI has previously hailed its success, saying the first wave, which had a budget of £25m, had identified £100m of savings for the trusts involved.

At a recent conference for finance staff, an NHSI director credited the second wave, which is ongoing, with identifying savings of £80m.

Sources told HSJ that a team within NHSI, led by productivity and efficiency director Jeremy Marlow, would instead look to support providers that have fallen furthest behind their financial plans in 2017-18 with a view to improving their outturn position. On hsj.co.uk, we have identified the 20 trusts that forecast the largest deterioration against their control totals midway through the financial year.

Earlier this month, HSJ reported that NHSI was also developing an internal team to succeed an improvement programme commissioned from American firm Virginia Mason.

Whitleblower raises concerns over ambulance delays

A whistleblower alleged on Friday that at least 40 patients in the East of England were “harmed or died following significant ambulance delays” in less than three weeks between mid December and early January.

The incidents are described in a dossier compiled by the source from an ongoing internal review at East of England Ambulance Service Trust. They include one account of a patient apparently freezing to death after a 16 hour wait for an ambulance.

The source estimated that the number of patients harmed or killed due to delays during December and January could be around 80 when the review has finished.

While HSJ cannot independently verify the claims, both Unison and North Norfolk MP Norman Lamb said they were working to support them. Mr Lamb said the evidence required a full investigation and raised “fundamental questions about the senior management”.

In a detailed statement, the trust said: “The trust had plans in place, however experienced extreme levels of demand over the new year period in particular. The trust was unable to respond to a very small number of the 50,000 calls we handled over a 15 day period as quickly as we would like. The trust is undertaking a rigorous analysis of that small proportion of calls…

“It is best practice to always review the effectiveness of any plans and the trust will be doing that. Depending on any preliminary insight, the trust will invite an independent review of our decision making process. The trust has also requested a system wide review of these periods of high demand and lost capacity.”

Read the trust’s full statement in the box here.

Concerns have been growing about ambulance performance in the East of England in recent weeks. In Essex, the death of an 81 year old woman in her Clacton home after waiting almost four hours for an ambulance was widely reported. She had phoned 999 complaining of chest pains. Earlier this week, Norwich South MP Clive Lewis raised concerns about deaths in the East of England in the Commons.