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

The auditor’s assessment

Just a few weeks ago, the National Audit Office published two reports laying bare the NHS’ recent financial health. In them, Parliament’s head auditor called for new financial architecture, described an overreliance on short-term fixes and highlighted the ballooning demand for capital infrastructure improvements.

But the head of the audit service further turned up the volume in a new interview with HSJ.

Gareth Davies, who took over as the NAO’s comptroller and auditor general last year, gave us a stern assessment of what he regards as some of the failed attempts to balance NHS books.

Mr Davies described the incentive-led drivers of the sustainability transformation fund as “essentially unacceptable”, said lending to struggling trusts which were unlikely to ever pay back their loans was “debilitating” and added that the type of trust borrowing that began in 2015 would not happen “in any other sector”.

Strong words, but Mr Davies, the former UK head of public services for audit and advisory firm Mazars, has now led work at the NAO to make the views of his office even clearer.

It will be launching a new code for its auditors in April which states auditors should have regard to specified reporting criteria, one of which is financial sustainability.

And, with the recent discovery of a £420m injection into the Department of Health and Social Care’s account to effectively bail out NHS overspend (in the first year of an improved funding settlement, no less), we can only guess how the NHS will score when the auditors come knocking again.

It’s good to talk

A closer dive into the NHS staff survey results has highlighted an association between good manager communication and better error reporting.

HSJ has teamed up with health and social care charity, the Picker Institute, and examined statistical relationships between responses to the staff survey questions regarding staff communication with managers and those relating to error reporting.

Although the correlation between questions does not prove a casual relationship, the data shows strong associations.

“We should be aiming for a safety culture where people feel their manager takes incident reporting seriously,” argued professor of workforce modelling at London Southbank University Alison Leary when asked about the data.

She pointed out other industries even incentivise incident reporting. Is it time for the NHS to take steps in this direction?