The must-read stories and debate in health policy and leadership.
Life is just too short
The role of an NHS trust chief executive has never been easy. Even when money was flowing, there were still incredible demands to reduce waiting times and deliver on projects like private finance initiative and foundation trust status.
You go to sleep at night (if you can manage to sleep) aware that any one of your 5,000 plus staff could do something that will land you and your organisation on the front pages or in court.
Add to that the endless financial challenge that is NHS senior management these days and it’s not hard to see why South Tees chief executive Siobhan McArdle has decided enough is enough.
In a stark farewell email to trust staff, Ms McArdle delivered a withering assessment of the environment she was working in – an unsustainable health economy with challenging regulators and no realistic prospect of a plan out of the quagmire.
Her letter showed highly unusual candour for an NHS chief executive but was a welcome dose of reality.
But the situation is, as so often with these things, not quite as it seems. Ms McArdle’s trust, and particularly its management, did not come out smelling of roses in a recent Care Quality Commission report, with regulators rating the trust as “requires improvement”.
In addition, morale and communication was said to be poor in places and variable overall.
A new leader will need to tackle these challenges and deliver for the trust and the region where Ms McArdle – for whatever reason – has not.
Red flag after blue lights firm fails
When a large business operating in a small market faces financial ruin, it can be an indicator all is not right in the marketplace.
So Daily Insight will watch with interest how the private ambulance sector responds to SSG UK Specialist Ambulance Service going into administration.
The company, which was bought by Spanish firm Servicios Socio Sanitarios Generales in 2017, is one of the largest private providers of 999 support to the NHS.
Some ambulance trusts rely on 999 support, with HSJ hearing individual trusts have sometimes had up to 15 per cent of their capacity delivered by the private sector.
But, at a time of many concerns over NHS ambulance capacity, what went wrong for SSG?
One factor (albeit likely of several) could be the new NHS ambulance response targets. Independent Ambulance Association chief Alan Howson told HSJ demand for private 999 support “fell off a cliff” after the new targets were introduced in 2017.
But he also warned the NHS has a “short-term” approach to commissioning 999 support from the private sector, with some contracts only lasting a couple of months. This abrupt approach makes it hard for companies to build business models around, and is one reason why much of the private patient transport market focuses its attention on non-emergency services.