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

The government may have turned its back on private finance initiative, but there are still dozens of existing schemes across the NHS with decades to run.

One building contractor has found itself in the headlines in relation to two schemes, one of which involves one of the UK’s largest cancer centres.

Concerns had been raised for years over fire and electrical safety hazards at the Bexley Wing at St James’ Infirmary in Leeds, which opened more than a decade ago and houses Leeds Cancer Centre.

These included the risk, due to the layout of the basement plant room, that a single fire could have wiped out both the main and back-up power supply to the cancer centre in one go.

Lendlease, the building contractor, has now been told to cough up £5m to fix the safety defects in the St James’s University Hospital building after a legal battle.  

This comes after the company agreed to pay £100m to Northumbria Healthcare in relation to defects at a hospital which had seen unevenness across floors, multiple collapses of drainage pipework and inadequate helipad lighting, among other issues.

The discharge disparity

Yesterday HSJ shone a light on the differences in funding being allocated to integrated care systems to support hospital discharge. 

Two systems are receiving more than £10m each while 10 are receiving less than £3m.

The £200m discharge fund is being dished out purely on a “weighted population basis”, rather than adjusted to reflect the current share of delayed discharge patients, unlike the adult social care discharge fund, announced in September, that was weighted towards areas with greater “no criteria to reside” bed occupancy.

North East and North Cumbria ICS received the largest proportion of the funding, with an allocation of £11.4m. Shropshire received the smallest with £1.7m – the ICSs with the largest and smallest weighted populations.

This is despite delayed discharge problems being significantly skewed to particular parts of the country, especially the South West.

Guidance issued late on Friday afternoon says the funding “should be used to purchase bedded step-down capacity plus associated clinical support for patients with no criteria to reside but who cannot be discharged with the capacity available through existing funding routes or the ASCDF announced previously”.

Funding will be held by NHS England, and integrated care boards will claim what they spend up to their total allocation value.

Also on hsj.co.uk today

In our expert briefing ImPatient, David Gilbert asks what patient leadership might look like in the drug licensing and pricing game, and we name the new chief executive of Derbyshire Healthcare Foundation Trust.