Today’s must read stories and debate

Uncertain future for Southern Health

Troubled Southern Health Foundation Trust has received a significant amount of regulatory oversight and intervention since the publication of a report in December which revealed the trust had not properly investigated and learned from the deaths of service users.

A highly critical Care Quality Commission inspection report followed, and an extra condition was added to the trust’s licence empowering NHS Improvement to make “management changes” if progress was not forthcoming. The trust’s chair was replaced shortly afterwards.

However, intervention from the centre could ratchet up even further – on Monday HSJ revealed that the trust could be broken up.

HSJ understands that Jeremy Hunt was due to be presented with options for further action on Southern Health over the weekend. These included splitting the trust into separate organisations and ordering another inquiry into the care it provides.

If it is broken up it could be split into separate organisations by service line – mental health, adult social care, community care and services for people with learning disabilities.

The fundamental question the health secretary will have to ask is this: will breaking up Southern Health make delivering quality care more achievable, or will another bout or organisational turmoil (the trust was created by a merger) be a pointless distraction which increases the risk of patients falling through the gaps?

Whatever the decision, it will not be made lightly.

In other Southern Health news, the failings identified at the trust in relation to dealing with the deaths of people with learning disabilities are not a one off, the country’s top learning disability doctor has said.

Dominic Slowie, NHS England’s national clinical director for learning disability, said the issue reflected a wider “society attitude to people with learning disability”, and that similar inadequacies were probably to be found in “lots of hospitals in the country”.

Should we stay or should we go?

For what surely won’t be the last time before 23 June, the NHS was dragged into the EU in/out campaign on Monday – this time by Brexiteer Boris Johnson.

The former Mayor of London said in a speech that A&E waiting times “are longer than they have ever been in the history of the NHS”, and that leaving the EU would allow the government to “put some more money into the NHS and try and sort out that problem”.

HSJ reported on Friday that in 2015-16, the English NHS recorded its worst yearly results for four hour waits in A&E since the target was introduced in 2003-04, so Mr Johnson has reason to be concerned about it. But the funding issue is much less clear. On Rob Whiteman, chief executive of the Chartered Institute of Public Finance and Accountancy, writes: “The EU has a profound and far reaching effect on healthcare provision in this country that is significantly more complex than its impact on the amount of money available.”

In recent months we have reported on how EU rules can affect new care model vanguards, patient records, patient safety and staffing.

Mr Whiteman points out that both Brexiteers and Bremainers argue that their position would ensure more money for the NHS, but there are other areas that should come into their thinking, such as the impact on the NHS workforce; learning from other European health systems; research collaboration; a possible Europe-wide policy to tackle obesity; and the TTIP trade agreement with the US.

He decries the “general lack of public awareness” of the EU’s influence (positive or negative) on public services – a CIPFA poll found 46 per cent of the public believe EU membership makes no difference to healthcare – and the risk that voters make “one of the most significant decisions in a generation on the back of a mountain of spin”.