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

NHS England elective chief Sir Jim Mackey’s refreshingly candid approach has long won him admirers among NHS managers – and his comments at last week’s HSJ Providers Summit again drew praise from local leaders, both in the room and in the comments section below our article.  

As we reported, he dismissed savings targets set for the most financially challenged trusts as “probably not really possible”, but warned that providers would still need to shed “the weight” they had put on during covid and that this will “hurt”.

Some will have viewed his dismissal of 5 per cent CIP targets for financially struggling trusts being achievable as another healthy dose of realism. But it will have likely ruffled feathers in the NHSE finance team.  

Sir Jim also put himself on a collision course with clinical leaders, after he called for the relaxation of infection control measures, and councils, whom he accused of not pulling their weight when it came to addressing the huge problems with delayed discharges.

But none of these hugely complex challenges will get addressed without leaders having tough conversations and taking tough decisions. You’ve got to break a few eggs to make an omelette.

Too big to fail?

University Hospitals of North Midlands Trust has published an independent review into concerns raised – and revealed by HSJ last year – about racist bullying and harassment within the organisation, principally among its medics.  

The probe found that the trust’s clinical leaders failed to tackle big personalities over a number of years, resulting in doctors who had become hardened to bad behaviour.

Of the 3,500 staff who took part in the survey, one in five doctors reported they had experienced bullying/harassment at the trust, with hotspots being in anaesthetics, critical care and theatres.

There was also a clear distinction found between the experiences of white and ethnic minority staff – with 60 per cent of ethnic minority staff who experienced bullying agreeing it was down to their ethnicity.

And problems were not just found between colleagues and managers – a quarter of staff reported they had experienced bullying from patients, something that is certainly a problem nationwide.

The trust has described the review as “hard hitting” and says it has already put measures in place to improve this culture, including reducing reliance on formal grievances and investing in training for managers and clinicians.

Also on today

In our comment section, Ray Olive says T Level training programmes at his trust in the North have helped to tackle the skills gap, and in London Eye, Ben Clover explains why the findings of the latest NHS Staff Survey made easier reading for chiefs in the capital than in other parts of the country.