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

Hundreds of people with a learning disability or autism are still stuck in hospitals when they do not need to be there – more than a decade on from the Winterbourne View scandal. 

That’s according to long-delayed reviews of the care of 1,770 people in hospital over an eight-month period to May 2022, which also warned of failures to monitor weight gain, which in some cases led to people developing diabetes.

NHS England’s safe and wellbeing reviews, sparked after the deaths of three people at Norfolk-based private hospital Cawston Park, revealed 41 per cent of inpatients assessed had needs which could be met outside hospital.

Separate figures also suggest NHSE is on track to miss its target to reduce levels of inpatients to less than half 2015 levels by March 2024. In eight years, there has been a 30 per cent decrease.

Care provided to people in hospital was also criticised – autistic people were subject to inconsistent and/or high levels of restraint, seclusion and segregation, and were prescribed antipsychotics despite no clear rationale for doing so. Some were placed in psychiatric intensive care units as “there was nowhere else to go”.

Hart to Hart

In HSJ’s latest Health Check podcast, NHS Providers’ new chief executive cautions against creating provider trusts which are extremely large.

Sir Julian Hartley tells us of his fears that leaders could lose touch with the front line. He also answers our questions about the role of collaboratives, as well as the shift from competition to system working, the risks of reintroducing a payment by results-style tariff, the importance of the promised long-term NHS workforce plan, and the growing voices questioning the future of the NHS model.

Sir Julian said: “My experience of provider collaboration has been very, very positive. Certainly in the West Yorkshire Association of Acute Trusts we worked very hard to focus on what we could do together to improve quality, to reduce waste, to manage workforce better, to do procurement, to reconfigure pathology, and vascular [services], and have been successfully doing so.”

Read the full interview here and listen to the podcast here.