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A dispute between the government and an NHS trust has brought the issue of rule breaking to the forefront, amid the long-running “partygate” row.

West Hertfordshire Teaching Hospitals Trust appointed former civil servant Matthew Coats in April and revealed this at a public board meeting that month.

But Mr Coats was subject to “Business Appointment Rules”, which apply to all civil servants who leave the service and move to jobs in other sectors.

All outgoing civil servants must seek advice from the Advisory Committee on Business Appointments about any jobs they wish to take up within two years of leaving, and no announcements about new appointments must be made while the process is ongoing.

ACOBA received Mr Coats’ application on 6 April and the trust made its announcement at its public board meeting on 7 April, which the advisory committee said constituted a breach of the rules.

The trust was accused of “putting its needs before that of the rules”, especially since Mr Coats said he had informed the trust of the process beforehand. But chairman Phil Townsend defended his decision robustly, saying it was made “in good faith and with the best interests of the health economy”.

He also said normally the trust would announce a new CEO “within days” of the final interview process, for its “credibility and stability”.

As good as it gets

NHS Confederation has said trusts are finding it “impossible” to improve on the number of delayed discharges due to the “collapse in the domiciliary care market”.

The warnings come as HSJ analysis reveals that the number of patients remaining in hospital despite being deemed “medically fit” to leave has continued to increase in recent months.

This is despite targets set by NHS England to reduce the numbers, and pleas to local leaders to make this an operational priority.

Stubbornly high numbers of patients being delayed in leaving hospital due to lack of social care is having a big impact on bed occupancy and patient flow. This is a key factor behind the crisis in emergency care, as patients face long waits in A&E for available ward beds.

The King’s Fund has said it would be a “marker of failure” if integrated care systems don’t make progress on the issue.

NHSE said a national taskforce is sharing best practice in improving discharge rates. Some trusts are launching their own domiciliary care services.