The must-read stories and debate in health policy and leadership.
- Today’s thoughts on covid and black communities: “They’re not going to offer us anything good first”
- Today’s latest on Leicester: ’Trust moved to change auditor when accounts were challenged’
A ‘stocktake’ of one of the original integrated care systems would not have made for easy reading for systems leaders. A review of the Bedford, Luton and Milton Keynes ICS found: “Senior relationships are poor and there is a lack of trust in the system. Relationships consistently emerge as a barrier and are strained by unclear accountability and authority.”
The ICS has long been hampered by claims that the ICS footprint doesn’t work and in reality operates as two separate systems, one developed around Milton Keynes University Hospital trust and the other around Bedfordshire Hospitals Foundation Trust (formed by a merger between Luton and Dunstable and Bedford hospitals).
The report by consultancy Carnall Farrar included anonymised comments from 38 NHS and council leaders in the system – and they are certainly colourful. One said “people don’t believe in the ICS and don’t want to operate as an ICS”. Another claimed that local authority partners were sidelined by NHS partners: “If Simon Stevens says jump, then NHS partners say how high?”
Leadership in the ICS has been overhauled in the last few months, with new leaders coming from national NHS England roles.
Former NHS England spec com director Felicity Cox became the new interim ICS executive lead in December 2020, and will also replace Patricia Davies as accountable officer for the Bedfordshire, Luton and Milton Keynes clinical commissioning groups which are merging in April 2021. In December, Nicola Kay also left an NHSE national role to take over the role of ICS programme director.
One can only imagine the job Ms Cox has on her hands to get the system cooperating again.
An ill thought out merger
This week HSJ exposed serious concerns from multiple whistleblowers over the safety and quality of haematology services at University Hospitals Birmingham FT.
Haematology services generally treat patients with cancer, needing stem cell and bone marrow transplants and prior to the pandemic UHB had two separate services across its Queen Elizabeth Hospital and Heartlands Hospital.
However, these services were merged and moved to the QE, following which staff claimed there has been a string of patient safety issues. Evidence covered by HSJ has revealed at least 14 members of staff left the service following the merger and several due to concerns over patient safety.
“In one very telling resignation letter a nurse told managers: I am witnessing strong and knowledgeable colleagues breaking down on each shift… For me, I came to the QE to improve cancer services for the patients, but I leave broken with the constant hauntings of the patients that have been let down by this poorly managed, ill-communicated and thought-out merger.”
A report from the CQC following HSJ’s story revealed similar concerns about haematology services, however, paints a very different picture, claiming there to be a “overall positive” culture within the service.