The must read stories to end the week

Shock double resignation

If you were shocked by the sudden departure of two acute trust chiefs over persistent failure against the emergency target, then you were supposed to be.

Ministers and NHS Improvement want to send a clear message to the rest of the system: underperformance of the kind seen in around 20 trusts nationally cannot become “normalised”.

The departures of Matthew Kershaw from East Kent and Libby McManus from North Middlesex were announced at lunchtime on Friday.

The message: if your A&E performance is consistently below 85 per cent, you will have to assure the centre that you have definitely done everything within your power to improve it, or face the sack.

How constructive this approach will turn out to be is already the subject of some debate.

Managers in Partnership chief executive Jon Restell tweeted: “There’s holding people to account and then there’s sacrificing to the gods. Which are these resignations I wonder?”

Meanwhile, Tracy Bullock, chief of Mid Cheshire Trust, observed: “Then most CEOs are doomed. [This] won’t stop us trying to do the right thing for patients and staff.”

The two resignations were voluntary, but clearly coordinated. Interestingly, NHS Improvement’s official response emphasised the need to prepare for winter and the possible coming flu outbreak – giving an already alarming story an additional ominous overtone.

Capital situation looking foggy

Jon Rouse, Greater Manchester’s health supremo, was one of the first prominent NHS figures to speak out on the social care funding crisis last year.

This warning gathered momentum over the winter and eventually resulted in the government coughing up an extra £1bn in the spring budget.

So Mr Rouse’s latest comments, around capital funding, feel like an important intervention.

He says the government’s current regime is like “driving into fog” and it’s impossible to create “proper” plans and maximise the opportunities for private sector investment.

As a former director general at the Department of Health, his thoughts will probably attract greater attention in the corridors of power than those of your average NHS boss.

And if Greater Manchester – viewed by national leaders as one of the leading health economies – says its plans are being hampered then one might hope the Treasury will listen.

Jim Mackey has expressed similar concerns during his time as NHSI chief executive, and is likely to be pressing the case further in the run up to the autumn budget.

Unions demand pay rise

After the row over the pay rises for police and prison officers earlier in the week, it was only a matter of time before the headlines turned to the NHS.

And so it was on Friday, as 14 unions representing nurses and other NHS staff demanded a 3.9 per cent pay rise, plus a one off payment of £800 per employee. They estimate this would cost £2.5bn.

Those who would oppose a more generous pay rise for health workers seem to have become fewer and fewer since the election, but the real debate is where the money would come from.

As NHS Confederation chief executive Niall Dickson points out, any attempt by the government to meet the pay increase costs through existing health budgets would be a “disaster”.

Interestingly, the British Medical Association was not among the 14 unions, and is still perhaps licking its wounds from last year’s junior doctors’ strike.