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

No calm before the storm

The East of England Ambulance Services Trust heads into what was already set to be a tough winter with fresh uncertainty surrounding its leadership after chief executive Robert Morton announced on Friday he will step down later this year.

The announcement followed a chaotic period including allegations patients were harmed because of ambulance delays, consistently poor response time performance and cultural concerns highlighted by inspectors earlier this year. 

His supporters and detractors remained equally passionate in their positions following Mr Morton stating he would leave at an unspecified date this year citing personal reasons.

Trust chair Sarah Boulton said she was “saddened” by his decision and that he left a “great” legacy. Critics like local MP Norman Lamb said he presided over an organisation with a “rotten” culture and his departure was not before time.

Whatever the reasons for the chaos engulfing EEAST, one person can never be held solely accountable for the failings, or success, of an entire trust – even the chief executive.

But by appointing a new chief, the organisation’s leadership could seize the opportunity to start a new chapter with the parts of its workforce it has been at loggerheads with – an issue which been the root of much of its cultural problems.

The leadership must also ensure they are visible this winter and be seen leading from the front, after valid complaints that too many of the trust’s executives – including Mr Morton – were on annual leave during the traditional pinch points over the festive and New Year period last winter.

The trust’s long standing problems around performance and staff shortages will most likely take years to address, especially with the general workforce shortage being felt particularly acutely in some of the far flung rural areas the trust covers.

But the first priority will be to try and ensure there is not a repeat of the widespread long delays last winter. This will require not only the trust to perform better, but also the system as a whole.

Acute trusts, for example, must significantly improve their handover delay performance which hugely exacerbated EEAST’s problems last winter, and no doubt contributed to the raft of long delays suffered by patients.

The drugs don’t work

Asking the government to speed up when it comes to Brexit may be a tall order, but the pharmaceutical industry has done just that, urging an agreement to secure the approval of new generic and biosimilar drugs in the long term.

Although the Medicines and Healthcare products Regulatory Agency has reassuringly confirmed the generic supply for the next eight years should be unaffected, it has warned a “streamlined approach” is needed to approve UK marketing authorisation applications beyond that timeframe.

To reach such an agreement, it is crucial Britain maintains a good relationship with the European Medicines Agency. This was highlighted again this weekend with news in the Guardian that Britain no longer has a leading role in evaluating new medicines for patients across the EU.

It has been said the removal of the MHRA’s expertise is the EU’s loss, but it also highlights the impact Brexit is already having on the pharmaceutical industry and the pressure on negotiators to ensure patients have access to medicines – and that British industry is not irreparably damaged.