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

Same old spots

Can a leopard change its spots? According to Chris Hopson, chief executive of NHS Providers, members believe the national regulators are committed to change. But he makes clear this change will not happen overnight.

Mr Hopson told HSJ ahead as NHSP’s annual conference got under way in Manchester how it is common to hear of NHS chief execs still subject to aggressive “top down command and control”.

Baroness Dido Harding, chair of NHS Improvement since 2017, has said numerous times she wants to improve the culture from the top down and the interim people plan focussed on making the NHS a better place to work.

Mr Hopson, however, warned the approaching winter would be a true test of whether Baroness Harding’s promises are more than just words.

“You can’t abandon performance management and accountability but everyone in the system is looking for more support,” he said.

Mr Hopson also warned NHS staff cannot be squeezed any more and called on frontline leaders to take matters into their own hands, “wake up” and stop waiting for Health Education England and the government to take action on workforce pressures.

Elsewhere at the conference

Nine days after prime minister Boris Johnson announced major infrastructure projects for the NHS at the Conservative Party conference in Manchester, trust chiefs descended on the city for their own annual chinwag.

In a sign of how important workforce issues have become – and the salience of the “command and control” issue discussed above, the NHS Providers conference kicked off with a discussion on culture and inclusivity, with several big names.

NHS Improvement chair Dido Harding suggested many answers to improving culture could be found in Care Quality Commission reports for “outstanding” trusts, while Health Education England chair Sir David Behan called for a debate over an “accountability framework” to allow managers to admit mistakes without being disproportionately castigated.

There was an exciting pause when CQC chief executive Ian Trenholm apprehensively pondered a question about whether trusts should be rated “good” or “outstanding” if they were poor on inclusivity, but ultimately his answer was non-committal.

Later in the day, all eyes were on NHS England chief executive Simon Stevens. Sadly though – while he confirmed he wanted to see more acute beds open this winter and criticised the English Cricket Board – it was far from his most memorable appearance at a conference.

Mr Stevens did at least spare the time to pop next door to speak to delegates at the Healthcare Estates conference, organised by the Institute of Healthcare Engineering and Estate Management, where he thanked NHS estates directors “and partners” for “keeping the show on the road” despite a decade of little capital investment.

He also urged trusts earmarked for seed funding to develop capital plans to access cash during 2025-30 to push ahead with the work, indicating that some schemes could even get the green light earlier.