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

Not all about waiting times

When it comes to waiting times, early intervention in psychosis services are ticking off their to-do list nicely. In quarter two of 2019-20, 78 per cent of patients were seen within two weeks against a national target of 60 per cent. 

However, this achievement takes on a new light when you consider not all those patients are receiving the same level of National Institute for Health and Care Excellence recommended care. In other words, if you’re a patient, the type and quality of service you receive varies greatly depending on where you live, even if you’re seen within two weeks.

When EIP services were elevated to a national priority within the Forward View for Mental Health, NHS England said it wanted at least 25 per cent of clinical commissioning group-commissioned services to be delivering “level three” NICE recommended care by the end of 2018-19. Level three effectively means the service is performing well against the eight core standards set out by NICE.

At the end of 2018-19, 18 per cent of services were graded at level three. 

There is also huge geographical variation. While just 6.3 per cent of the East of England services meet level three standards, 35 per cent of services in the North West hit this target. 

Time to get building?

The long-planned Kent and Medway stroke reconfiguration has taken a step closer to becoming a reality. 

The judicial review decision on Friday has made it increasingly unlikely campaigners will be able to stop the establishment of three hyper acute stroke units and the closure of three others. None of the eight arguments put forward by the campaigners were successful — although Mrs Justice Farbey noted two were “arguable” and would warrant judicial review, before ultimately finding in favour of the commissioners. 

There is one more hurdle to overcome: the recommendation of the Independent Reconfiguration Panel to health and social care secretary Matt Hancock, after Medway Council referred the plans to him. The IRP’s verdict is expected this week.

Assuming the IRP does not call for a fuller inquiry, only an appeal of the judicial review decision could stop the changes going ahead.

All three designated units require some building work. At Maidstone and Darent Valley hospitals, construction could start quickly — meaning the planned go-live date of April 2021 for the changes in the north of the county and Medway is possible.