The must-read stories and debate from Monday

What’s the problem?

HSJ’s comment editor Andy Cowper has given his take on the resignation last week of two trust chiefs over poor A&E performance.

He writes: “HSJ’s revelation last week that two chief executives had been pressurised into resigning is a depressing reminder that those in political charge of the system are neither clear nor sure what the problem is that they’re trying to solve.

“If sacking chief executives (yeah, sure, they resigned…) were a solution to the problems facing the NHS, then the system would have become perfect over the past decade. The system didn’t become perfect, and the problems weren’t solved.

“There are times when sacking a chief executive can be the right decision: unfortunately, the system is far from consistently good at noticing when those times are.”

Meanwhile, our analysis has found 21 trusts whose performance against the four hour emergency target has been consistently below 85 per cent since April.

HSJ understands that ministers and NHS Improvement do not want to allow performance on emergency care to be “normalised” below 85 per cent, and last week’s resignations were a clear warning to CEOs that they must do everything within their power to improve.

East Kent Hospitals University Foundation Trust has the worst performance, slumping from around 78 per cent in June to 70 per cent in August. Its chief executive Matthew Kershaw resigned last Friday.

However, there are several trusts with performance worse than that of North Middlesex, whose chief Elizabeth McManus also resigned.

Southern Health guilty again

Southern Health Foundation Trust has pleaded guilty to breaching health and safety law over the death of a teenage patient.

The prosecution was set up by the Health and Safety Executive after 18 year old Connor Sparrowhawk drowned in a bath following an epileptic fit while he was in the care of the trust at Slade House in Oxford in 2013.

Julia Dawes, interim chief executive of the trust, said Connor’s death was “entirely preventable” and a “constant reminder” of why the trust needs to improve.

Southern Health will be sentenced on 12 October – when it will also be sentenced following its guilty plea to a Care Quality Commission prosecution over safety failures at Melbury Lodge, where a patient broke his neck after he fell from the roof.