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

Repeated variation

The Getting It Right First Time project issued its second report of the year just before the general election purdah period descended.

The team, which looks in-depth at the performance and costs of different medical and surgical specialties, examined ear, nose and throat surgery across the country.

As with any GIRFT report they found significant variation in cost and outcomes, but more worryingly they found the number of readmissions was significantly higher than first thought, and that there was no discernible reason why.

The variation didn’t seem to correlate to the size of the unit, as they do with many specialties, but there were nonetheless worrying gaps in senior cover in some places.

Like many specialties, a lack of consultants and mid-grade doctors made hitting waiting times difficult and commissioners in some places seem to have unilaterally removed ear-pinning from the list of things the NHS will pay for.

It was not the most damning GIRFT report ever issued, and as always is slightly neutered by old data and anonymisation of outliers, but two small worrying points emerged; negligence cases brought in ENT cases often could not be defended because the proper records weren’t kept; and in many cases teams were completely unaware legal action had been brought.

Disciplinary record

Chief people officer Prerana Issar is calling for professional regulators to help shape a single framework for how the NHS handles disciplinary procedures and concerns about its staff.

According to Ms Issar there is an appetite among the HR community to develop one - and she wants a framework currently used by just doctors and dentists to inform this new piece of work.

This was all part of a letter, sent by the CPO this week to all professional bodies and regulators, in which she also asked them to review guidance produced for managers. This springs from work done by a national advisory group set up after the death of nurse Amin Abdullah in 2016.

An independent investigation published last year was highly critical of behaviour of individuals at Imperial College Healthcare during the disciplinary process against Mr Abdullah.

Ms Issar made it clear the national regulator expects to be “consulted on” the production of any new management guidance.