HSJ’s essential round-up from Tuesday

You owe it to the children 

London specialist trusts enjoy an enviable position serving the international private patient market.

This is worth tens of millions of pounds and forms a considerable slice of the overall private work done by NHS organisations in the capital.

But there are significant headaches that go along with that, as the case of Great Ormond Street Hospital for Children shows.

Trusts will sometimes be forced to tolerate bad behaviour and late payments from customers who know they have a lot of choice of where to be treated. Organisations are wary of losing follow-up business if debtors are pursued too vigorously.

Work from the foreign embassies in London is also lucrative, but they can be surprisingly bad customers. A small number of consultants with the right contacts in these places can charge high prices to bring this work to an NHS trust.

GOSH has a turnover of £444m and was owed £30m for IPP work at the end of August. In the last financial year, the trust’s income from this work stream was £55.2m.

The identity of the customer that GOSH is pursuing legally for £1.5m is not known, but IPP work formed roughly 11 per cent of the trust’s income in 2016-17. So, while unpaid debts and late payments are an issue for several other London teaching hospitals, not many of them are as exposed as GOSH.

Playing nurses

Concerns that NHS trusts have been wrongly branding care staff as nurses even though they are unqualified and not registered has prompted action from England’s most senior nurses.

A letter signed by NHS Improvement’s Ruth May and NHS England’s Jane Cummings has warned trusts not to describe care staff as nurses and told them to check they are not already doing so.

The chief nurses have also warned providers to make sure they advertise posts with the correct titles, linked to education and qualifications.

The letter came after research by Professor Alison Leary at London’s South Bank University revealed that hundreds of care staff had “nurse” or “advanced” in their job title when they shouldn’t have.

Out of a database of over 17,000 staff, Professor Leary found 595 different job titles for qualified nurses working in specialisms but with various levels of education and experience.

She said advanced nursing practice should be regulated and the title “nurse” protected like “registered nurse” is.

The May/Cummings letter said there needed to be more discussion about the issue of advanced practice, but unfortunately the Department of Health and NHS England declined to answer questions from HSJ on the issue, which Professor Leary described as a patient safety concern.