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

Mounting concerns

There are mounting concerns about the safety of maternity patients at Shrewsbury and Telford Hospital Trust. More than 100 cases are now set to be investigated by an independent expert and today HSJ has revealed the Care Quality Commission has its own fears over the trust’s services.

The details of a CQC Section 31 enforcement notice letter to the trust, passed to HSJ, are frighteningly similar to the findings of an independent review into the death of one baby at the trust in 2009.

Baby Kate Stanton-Davies died because her mother was not properly risk assessed and opportunities were missed on multiple occasions.

In its letter to the trust, the CQC has cited the same issues of high risk mothers not being adequately assessed, best practice guidelines not being followed and a lack of consultant involvement.

As Kate’s mother rightly said to HSJ, how long does it take to correct these issues? In recent weeks, the trust has said its services are safe and dismissed concerns as scaremongering.

While the investigations into alleged poor care are yet to confirm any concrete findings, the CQC’s fears, coming almost a decade after the same issues were identified, are extremely concerning.

Progress on pathology

The drive to consolidate pathology services is developing at a mixed pace across the country, but one area forging ahead is south east London, where health chiefs have put a large outsourcing contract on the market.

The procurement, run by the South East London Pathology Programme Board, is searching for a company to provide the full range of pathology disciplines for the trusts covered by the tender.

It comes ahead of the expiration of the contract for the current service (held by part NHS joint venture Viapath), and amid the ongoing drive from NHS Improvement to save £200m by 2021 by establishing pathology networks.

There are eight trusts in total (four acute, three mental health, and one specialist), and the tender looks to be the biggest published for pathology services since Lord Carter’s 2016 review of hospital efficiency.

However, the trusts involved in the procurement differ significantly from the network originally proposed by NHSI.

Two of the acute trusts (Epsom and St Helier University Hospitals and East Sussex Healthcare) are onboard, despite NHS Improvement believing the two trusts are better suited in other networks.

Another trust in the NHSI’s proposed network, Lewisham and Greenwich Trust, has opted against taking part in the procurement, because chiefs are exploring options to keep their pathology service within the NHS.

NHSI would not comment on what action it would take against the trusts which defy its plans.

However, the fact that Epsom and St Helier, East Sussex, and Lewisham and Greenwich have not acquiesced to NHSI’s proposals could encourage other trusts to resist the regulator’s wishes.