Wednesday’s must read health stories and debate

Mackey: ‘We dropped a clanger but we fixed it’

When Jim Mackey leaves NHS Improvement this autumn, we will dearly miss his zero-nonsense style.

In an exclusive interview with HSJ, the NHSI chief executive was typically upfront about the provider sector deficit for 2017-18, the regulator’s recent U-turn on agency staff, and winter pressures.

He said: “The provider sector won’t be in balance in 2017-18. It’s possible to get there in 2018-19, ceteris paribus and all that. But we’re not in control of all those other things.” He said even the timetable to achieve overall balance in 2018-19 was “very, very risky”.

In a further demonstration of candour, Mr Mackey said “silly” community bed closures had made winter even more difficult for acute trusts. On the standoff between trusts and locum doctors over new tax rules – with some agency staff and contractors refusing to work unless trusts compensate them for tax and NI payments – he said: “I don’t know how they’re on the register as doctors – if that’s doctor behaviour, I don’t know how that will work.”

Even by his standards, Mr Mackey’s phraseology was more colourful than you might expect from a senior NHS figure.

NHS Improvement announced rules to prevent trusts from using agency staff who are also employed by the NHS in February, but then said it was “pausing” the policy last week after the Royal College of Nursing warned it could drive more nurses to work in the private sector.

Mr Mackey’s response: “It’s my fault, I didn’t read every line of the document and then eventually did read it and thought ‘oh poop, I wish I’d read that bit’.

“What I wanted was to follow the principles of the junior doctors’ deal, when we said you can work elsewhere but try to offer that to your local employer first. That’s what I would want the nurses to do. We’ll try to do it properly now and engage with the Royal College of Nursing, etcetera.

“We’re trying to foster this thing about being a learning organisation and every time we drop a bollock we get slaughtered. There’s something really bizarre in all of that. We dropped a clanger but we fixed it.”