Daily Insight: Leader of the alliance

Dalton’s staying put

When Sir David Dalton penned a joint letter with Jim Mackey about the importance of A&E performance, it felt like a clue as to where the NHS Improvement torch was heading.

But in an interview with HSJ, Sir David clearly says he doesn’t want to replace Mr Mackey. He wants to be chief executive of the Northern Care Alliance Group.

What’s that?

It’s the new name for the “group” or “hospital chain” that now oversees the services run by Salford Royal Foundation Trust and Pennine Acute Hospitals Trust.

Although the trusts must still fulfil their statutory functions, and be regulated separately, their decision making has been devolved to a committee in common, which effectively manages the services.

Beneath the group, the hospitals have been structured into four “care organisations” centred around the hospitals in Salford, Oldham, Bury/Rochdale and north Manchester, with operational responsibility delegated to new leadership teams for each organisation.

Within two years, it is planned that Salford Royal will complete a formal acquisition of Pennine Acute, after which the statutory and regulatory requirements would become more straightforward.

Sir David and Salford Royal chair Jim Potter took over the leadership of Pennine Acute last year after it was rated inadequate by the CQC.

In a briefing document this week, the trusts said these arrangements had enabled a “rapid handover of responsibilities at virtually no cost to the taxpayer”, adding this was in “contrast to mergers [that] often take considerable time and require significant legal fees and management costs”.

It’s hard not to read that as a dig at the hospital mega-merger that has just taken place next door.

Staff have their say

HSJ has published details of NHS England and NHS Improvement’s previously uncirculated staff survey results. The surveys were conducted last year, and requested under the Freedom of Information Act in the spring.

We’ve only published the results now because getting NHS England’s released took rather longer than the 20 day statutory limit for FOI replies – the results were only released after Simon Stevens received a threat of contempt of court proceedings from the Information Commissioner’s Office.

The results are a mixed bag for NHS England, and pretty depressing for NHSI.

NHS England’s results were in line with the wider service on bullying and discrimination, for example, and its overall staff engagement score was rising.

However, some parts would have made for awkward reading at the top of the organisation. Just 41 per cent of NHS England employees last year believed decisions taken by senior leaders reflected the organisation’s values and behaviours – values have been a consistent theme for Mr Stevens since he took over in 2014. Meanwhile, less than half of employees agreed it was safe to challenge how things are done.

A comfort on these points for NHS England is that its results were not as bad as the Department of Health’s.

The fact that only 47 per cent were able to do their jobs without working excessive hours should also be alarming.

NHSI’s scores reflect an organisation unhappily undergoing a merger: staff reported poor communication, a lack of vision from senior leaders, a widespread intention to work somewhere else, and low levels of pride in their organisation.

Something to bear in mind next time someone suggests merging NHS England and NHSI.