Daily Insight: Houses not in order

Missed opportunities

Last year, then health secretary Jeremy Hunt issued a stark warning to private sector hospitals that they needed to get their house in order on safety after a series of deaths.

Now, another coroner has issued a warning about the ability of private hospitals to respond to deteriorating patients and to escalate care quickly enough.

Simon Healey was referred out of the NHS by his consultant Daniel McGrath because he didn’t want to wait for surgery to remove his colon cancer. The same consultant carried out the surgery under practising privilege rights with Ramsay Health Care.

But, when Mr Healey deteriorated, opportunities to save his life were missed. An expert told the inquest the leak in Mr Healey’s bowel should have been detected five days before his death. Had it been, Mr Healey would have survived.

His wife Alison told HSJ her husband would never have chosen to go private if he had known the hospital lacked the ability to respond to possible complications.

The case is tragic, and while deaths like this may be rare, they do raise serious questions about how best to treat the rising number of patients needing treatment at a time when the NHS waiting list is growing.

More patients may find themselves in Mr Healey’s position – frightened and wanting treatment as fast as they can. The private sector will undoubtedly be keen to cash in on this rising demand.

But the NHS and government has a duty of care to these patients to ensure they are not being put at unnecessary risk. Private hospitals make substantial profits and they need to demonstrate they are not cutting corners by employing too few doctors on site and relying on off-site consultants to review patients who may need emergency critical care responses.

The new (sort of) deputy chief

Amanda Pritchard, Guy’s and St Thomas’ Foundation Trust chief executive, was today named as the chief operating officer of NHS England and Improvement – effectively a deputy chief executive post in the joint regulatory organisation.

Ms Pritchard’s name has been in the frame since the post was created on the infamous Breakfast Meeting of the Long iPad Pros, when NHSI chief Ian Dalton and NHSE deputy Matthew Swindells were sacked, and the modern NHS’ answer to the Night of the Long Knives.

She fits the bill rather well, having served as chief of probably the NHS’ most prestigious provider organisation, kept it upright in the very rough waters of recent years, while playing its part as a system player rather than pulling up the ladders when the going got tough.

Ms Pritchard hasn’t worked in the NHS’ regulatory tiers – often an ask for this kind of role – and her only job at the centre was a short stint in 10 Downing Street back in 2006. Yet being based just across the Thames from Whitehall, and a few stones’ throws from NHSI and NHSE offices (not to mention a previous stint in senior roles at Chelsea and Westminster) means she will have spent time rubbing shoulders with power brokers, and may be wise enough to the chaos of working closely with government.

A number of those discussing the move say she also brings a healthy style of leadership to the national bodies, with one HSJ reader citing a “more systems-focused approach to vision, leadership and purpose”.

Some have commented on the value of having a woman at such a senior level in NHS leadership, which has been largely absent in recent years. One person, aware of the potential for a skilled operator still fairly early in career to climb the ladder still further, says: “Finally… a woman in the second in command job (and maybe first ultimately).”

Critically, however, as Daily Insight went to press, the status of the appointment was unclear. Guy’s staff have been led to believe it is a secondment, from which Ms Pritchard may return, rather than a permanent move. Perhaps longevity is always uncertain in such roles, but HSJ is looking into it.