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

Lost to the system

Autism services in South Staffordshire have been under fire for some time, and in October they transferred from social enterprise Midlands Psychology to Midlands Partnership Foundation Trust on an interim basis. Nearly six months on, the services are still facing difficulties.

The latest complaint is parents of children trying to access the service fear they have been “lost to the system” after uncertainty and delay arose around which case files should be handed over.

The trust told HSJ it received 187 files for children awaiting an autism diagnosis assessment in October and, to date, has completed 15 of them. However, it also said it received a further 306 files earlier this month for children who still needed to be assessed.

However, Midlands Psychology chief executive Angela Southall told HSJ her organisation had been instructed not to hand over certain files, adding: “There seemed to be some deliberate confusion.”

Those with a long memory may remember a similar situation was alleged when the social enterprise took over the services from child and adolescent mental health services in 2011. 

The services have faced a difficult recent history. In 2018, Staffordshire commissioners received the initial findings of an independent review into autism and children and adolescent mental health services across the south of the county. This raised immediate concern for the safety of children and warned commissioners they needed to act. 

The situation came to a head in summer 2019, when NHS England called a risk summit meeting with the providers, clinical commissioning groups and Care Quality Commission. By this point, the commissioners had indicated they planned to reprocure the services. 

However, September came around and the CCGs had not launched any procurement. They eventually decided to hand the services to the local trust. Conservative MP for Burton, Andrew Griffiths, later described the process as being carried out “back of a fag packet” — then wrote to Matt Hancock about his concerns, who in turn asked Sir Simon Stevens to review the situation.

NHSE has not confirmed the outcome of this review — or if such a review has even been started — but, considering it is vulnerable children at risk, national leaders may want to keep a close eye.

A list you don’t want to be on

HSJ revealed last month that, when the Health and Safety Executive inspector called, around two-thirds of providers were caught breaking health and safety law.

At the time, the HSE told HSJ the providers in England, Wales and Scotland it had inspected and how many were breaching laws. However, it could not be revealed which of the providers were breaking health and safety law or on what grounds. Until now.

Using a freedom of information request, HSJ has obtained the full list of failings the HSE found at NHS providers, including eight English trusts and three Welsh health boards.

Between them, they received 40 official warnings over a two-year period, with HSE setting deadlines to make required improvements.

Among the more serious health and safety law breaches were warnings raised over asbestos management at United Lincolnshire Hospitals Trust and exposure to blood-borne viruses and sharp instruments at East and North Hertfordshire Trust. Half a dozen providers were also found to be failing on violence and aggression policies.

A further 18 providers in England and Scotland were found to be breaking health and safety laws, although HSE did not deem these breaches serious enough to issue enforcement notices.