The essential and exclusive stories to round off the week

Workforce crisis, part one

HSJ revealed on Friday that wards have been closed and liver transplant operations cancelled at Leeds Teaching Hospitals Trust because of a shortage of critical care nurses.

Leaked documents and emails seen by HSJ show the trust was forced to close two critical care wards at Leeds General Infirmary and St James’ University Hospital.

As a result, eight patients awaiting the vital transplant operation have missed out on the procedure because there were no intensive care beds available to take them.

Senior clinicians who have blown the whistle said the region was suffering from a critical care bed crisis and the most severely ill patients were being shunted to other wards and recovery areas. Multiple sources blamed the introduction of agency caps for exacerbating the situation.

The trust admitted it was experiencing “ongoing difficulties” in recruiting intensive care nurses, which it said was common across the country. It said the ward closures were a temporary measure.

“These changes were a formal response to existing staffing shortages that were already present prior to this time and had been leading to ‘ad hoc’ bed closures across all units.

“They do not represent a sudden deterioration in our position but a planned operational response to ensure safety.”

Workforce crisis, part two

The tale from Leeds followed the news from Lancashire Teaching Hospitals the previous day that it had been left with half the number of middle grade doctors needed to staff its two accident and emergency departments at Chorley and Preston. The Chorley A&E will be downgraded on Monday to an urgent care centre from 8am-8pm.

Trust chief executive Karen Partington said one of the reasons she had struggled to recruit enough doctors was that other providers were not “holding the line” on agency pay caps, so locums instead plump for trusts paying over the cap.

NHS Improvement has now insisted “it is not true to say that caps on agency spend have contributed to this problem”.

Battle at the BMA

Leaked emails from inside the BMA show junior doctors’ committee chair Johann Malawana urged his union colleagues to exclude paediatric services from next week’s emergency care strike.

Dr Malawana warned it would be a “difficult line to defend” but the plea was rejected by the committee and a full withdrawal of labour by thousands of trainee doctors is set to go ahead from 8am-5pm on 26 and 27 of April.

It will be the first time that junior doctors have taken strike action including non-provision of emergency care to NHS patients.

NAO gets stuck into UnitingCare

The National Audit Office has opened an investigation into the sudden collapse of a £725m older people’s services contract in Cambridgeshire just eight months into its five year deal, HSJ exclusively revealed on Friday.

The probe will be the fourth investigation into the deal, which ground to a halt when the provider, UnitingCare Partnership, announced in December that it would be handing back its contract.

The NAO will focus on the factors that contributed to the contract’s collapse, said correspondence from its auditor general Sir Amyas Morse, seen by HSJ.

Heart surgery hospitals with work to do

Half the hospitals that perform major children’s heart surgery do not currently meet all the new safety standards being implemented by NHS England, our research has found.

Four of the 11 hospitals told HSJ they have assessed themselves as meeting the new specifications, while five said they are working to meet them within the five year timescale set down by NHS England. One did not respond, while another did not give a clear answer.

The new standards, which NHS England started monitoring this month, need to be met by 2021.