Daily Insight: Let a thousand plans bloom

Right-wing commentators are fond of drawing parallels between the NHS’s pervasive target culture and superannuated Soviet industries (often tractor production).

Yet the health service shares another characteristic with the USSR: an obsession with planning.

NHS England has ordered a new wave of five-year plans that will steward the health service into the new era envisaged by another plan, the government’s 10-Year Health Plan (for which we are still awaiting a delivery plan).

Integrated care boards, which are in the process of cutting staff and merging, will draw up strategic commissioning and population health plans. Providers will draft “integrated delivery plans”. And the NHS – working with local government and other partners – will work up “neighbourhood health plans”.

In a thinly veiled swipe at the quality of previous rounds of plans, which scarcely lasted six months – let alone the year they covered – this new class of document must be credible, deliverable and affordable. Boards should play an “active role” challenging them – rather than simply signing off the final version.

And if this cornucopia of five-year strategies isn’t enough, the plans will have to be refreshed every year.

Mortuary pressures in the spotlight

Worcestershire Acute Hospitals Trust has been criticised by the Human Tissue Authority for continuing to store bodies in an external bank of fridges in a car park at Worcestershire Royal Hospital.

The facility was installed during the pandemic to manage excess demand but has remained in use due to ongoing capacity pressures.

Inspectors highlighted five major and four minor shortfalls, warning the car park location does not adequately protect the “dignity of the deceased” and noting risks posed by an uneven loading bay surface, which could cause accidental damage to bodies.

The HTA also flagged insufficient CCTV coverage, raising concerns about security, and criticised the lack of formal confirmation when babies are transferred to other establishments for post-mortem examination.

The trust said the external store was in a small staff car park that was as close as possible to the mortuary, access-controlled, and monitored by CCTV, but acknowledged the need for improvements. A spokesperson insisted the trust is “committed to empathetic and dignified care” and confirmed an action plan is under way.

The warning follows a broader national focus on mortuary standards and security, heightened by past failings elsewhere. Earlier this year, the HTA reported over a quarter of hospital mortuaries were not compliant with security requirements.