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

NHS alert over human waste stockpiling

Up to 50 trusts are on standby to implement contingency plans for their waste disposal after a major contractor was found to be stockpiling human body parts and dangerous waste.

Healthcare Environment Services faces enforcement action from the government after failing to dispose off waste transported from NHS hospitals in accordance with regulatory timeframes.

In July, inspectors from the Environment Agency found the company was storing 350 tonnes of waste, including amputated limbs, infectious liquids, cytotoxic waste linked to cancer treatment, and hazardous pharmaceutical waste at its Normanton site, which is five times more than the 70 tonne limit.

Such was the concern at government level that health and social care secretary Matt Hancock chaired a COBRA meeting on 13 September.

The excess waste at the site has since been “tidied up” and “all anatomical waste placed in refrigerated units”, according to NHS England documents leaked to HSJ.

However, capacity problems remain across the company’s other sites (HES runs five sites in England), and HES’s contracts with the trusts could collapse following the government’s enforcement action.

The NHS England documents from the middle of last month reveal that regulatory action against HES was “expected to lead to imminent cessation of waste collection by HES”.

Affected trusts are on standby to store their waste at hospitals in specialist trailers provided by the government as part of a £1m contingency package, in case the situation deteriorates.

The company blamed the overflowing waste on a reduction in the UK’s high temperature incineration capacity in the last few years.

Earlier this year, HES was at the centre of a waste management dispute between NHS England and SRCL, as the former looked to combat what it saw as excessive profits in the sector.

The Department of Health and Social Care confirmed to HSJ the government will review the way contracts are awarded to clinical waste disposal firms in the future.

An anonymous reader said of the debacle: “Presumably they haven’t got a leg to stand on.”

Size matters

The NHS’s smaller hospitals received promising news in two parts this week.

On Tuesday the health secretary declared the era of shifting more activity into a smaller number of larger hospitals as “over” during his party conference speech – he implied this would be good news for the community hospitals beloved of rural shires; that may come as some surprise to those trying to get rid of these often inefficient facilities.

And today, a major NHS England commissioned review robustly argues for more support for smaller trusts and tells policy makers to resist the “kneejerk reaction” of closing or downgrade smaller sites as a first resort to addressing staffing shortages.

The Nuffield Trust review, exclusively shared with HSJ, sets out a wide ranging set of recommendations including national policy changes like a cost premium for remote hospitals, contractual changes, to local level changes like ending the practice of separating out services like ambulatory care. Read more here.

There are, however, also grumblings from large teaching trusts that, in fact, they’re the ones being hard done by The System.

University Hospitals Bristol Foundation Trust’s latest board papers are a case in point. They warn sustainability funding being baked into tariff will likely favour smaller hospitals “at the expense” of tertiary trusts, while national tariffs are likely to be “less favourable” in future for specialised services.

NHS England’s response to the review will be closely watched by trusts of all size.

Three senior female NHS leaders have been accused of sexual discrimination, by their former HR director.

Former HR director for Warrington and Halton FT, Roger Wilson has accused chief executive Mel Pickup and two other senior female board members of sexual discrimination.

HSJ readers may remember the name Roger Wilson as the NHS director, who agreed an “irregular” payoff deal with a midwife at the centre of the Morecambe Bay scandal.

These alleged actions at Morecambe Bay led to him being found guilty of gross misconduct whilst employed at Warrington and Halton.

The former director has since been granted permission to pursue an employment tribunal hearing over claims he was unfairly dismissed and discriminated against due to his sex.

The hearing, due to conclude tomorrow, could have major implications if Mr Wilson is successful.