Today’s must read stories and biggest talking points

David and Jim’s pep talk

After some local NHS leaders were urged to chant “we can do this” and improve A&E performance, some slightly more sedate – but significant – encouragement from Sir David Dalton and Jim Mackey.

In an exclusive article on, the Salford Royal/Pennine Acute chief executive and NHS Improvement boss have told hospital leaders not to neglect the four hour A&E target and to be “vigilant about the patient’s experience in your ED”.

HSJ editor Alastair McLellan observed that the intervention shows how worried the centre is that trusts are giving up on the target as impossible.

Sir David and Mr Mackey write: “Some people have said that the four hour standard is no longer relevant. We don’t agree. Meeting the four hour standard in our emergency departments is a patient safety issue…

“It is incredibly important though that we do not despair and accept things the way that they are. To do so would take us down the slippery slope of normalising things that we would all agree are unacceptable. On the occasions when the four hour standard is breached – it must never be acceptable to breach core standards of patient safety or patient care.”

Sir David has also joined the debate over NHS pay rises, after Jeremy Hunt said any new deal would be “linked to productivity”. Writing underneath our story over the weekend, Sir David said: “Rather than just rely on some high level, productivity indicator for the NHS, we should consider creating a link to the contribution of an individual or team to the goals and values of their employing organisation. Many organisations in many industries are able to manage an assessment process which reviews not only ‘what’ people have done but also ‘how’ they have done it. Delivery of objectives and behaviours are then given equal importance.”