The must read stories to round off the week in health policy

The turnaround 20

NHS Improvement really didn’t want much attention drawn to its turnaround programme.

This was conceived in 2015 but might be coming to a boardroom near you from April.

As we reported on Thursday night, the specifications are out and the people who designed them in Monitor/TDA are very cagey about the project.


Because it’s going to cost at least £10m, probably more, and will be deeply unpopular with the people running the 20 trusts where consultants will be sent to get help them grip on performance and governance issues. It could also look bad, after trusts were told to clamp down on the use of consultants for the regulator to then spend £10m on consultants.

But what else can the centre do?

At its last board meeting, NHS Improvement boss Jim Mackey made clear that large amounts of bailout have been shovelled out of the Treasury in the past 12 months, and in many places performance has got worse. What is a system regulator nominally at arm’s length from health secretary (but not really) to do?

The centre must suspect that amid the provider sector shroud waving, some places have simply lost grip.

Pushing for better paydays

Times are tight in the NHS, but surely the pay structure for non-executives of NHS trusts needs revisiting?

Letters obtained by HSJ reveal how the NHS Trust Development Authority lobbied government ministers to increase the standard rates for chairs at non-foundation trusts.

The rates for a trust chair range from £18,621 to £23,600 a year, whereas an FT chair can receive up to £67,500 a year.

If a trust wants to pay more than these rates it must be approved by the government, so there has been a piecemeal approach to increasing salaries.

This means the chairs at some small but challenged trusts, such as Hinchingbrooke, are currently paid more than their counterparts at some of the largest organisations in the country.

And is the job at a foundation trust really so different to warrant such a wide gulf in salary?

The letters, which were sent last year by the chair of the TDA at the time, Sir Peter Carr, suggest the Department of Health was receptive to the idea of increasing the standard rates, but the “timing was inappropriate”.

He said many trusts struggle to attract people to the job, with some getting just two applications when they advertise the role.

There would obviously be a cost to this, probably something in the range of £500,000 to £1m, but getting the right people in place during a crucial period for the NHS is surely worth the money.

HSJ’s added value

It’s quite widely acknowledged that the NHS could do more to share and replicate best practice. With this in mind, we’ve launched the inaugural HSJ Value in Healthcare Congress, which will take place in Manchester on 24 May.

We’ve created this event because every NHS organisation has a part to play in achieving the £22bn savings the health service needs to make as part of the Five Year Foward View. The service has to become more efficient and continuously improve to benefit patients and taxpayers alike.

The congress will showcase best practice, featuring 12 unique sessions, 36 case studies and 360 minutes of live learning. The congress’s mission is to make sure all attendees go away with a greater understanding on how they can replicate the efforts of successful case studies in their own organisations.