HSJ’s round-up of Friday’s must read stories and debate

Some clarity over STPs

Sustainability and transformation plans are never going to be an easy sell to the public, so it’s no surprise that NHS England want to keep a tight rein on how they are communicated locally.

Local areas have been told to publish summaries of plans by mid-December, but only once they’ve been “discussed” with national and regional communications leads.

In a note sent to local leaders this week, NHS England strategy director Michael Macdonnell said: “As you prepare for publication, we would like to work with you to ensure that plans are written in a way that gives the public a good understanding of the proposed changes…

“Roger Davidson [NHS England head of media and public policy], who will be coordinating nationally, has already been in touch with your communications leads to begin this process.”

The note, seen by HSJ, said it was important for the plans to “articulate tangible benefits for patients” in language that is “clear and compelling”.

The catch, of course, is that the STPs must work within extremely tight financial constraints, and achieve a balanced position by 2021 within the funding envelope announced last year.

NHS Providers chief executive Chris Hopson was pretty clear and compelling earlier this week when he said these constraints mean STPs are drawing up fantasy plans – many of which will involve hugely controversial reconfiguration or merger plans – which they know can’t be delivered.

Unpalatable pay decisions

The NHS has a workforce shortage yet the pressure on trusts’ finances means some are having to make unpalatable choices.

St George’s University Hospitals Foundation Trust in London has confirmed to HSJ it plans to make a 10 per cent reduction in its pay costs during the next six months.

Critics of the plans may point to the trust’s high vacancy rate, which stands at 16 per cent and for nursing staff the vacancy rate was even higher at 20 per cent.

The trust said it planned to continue recruiting to clinical roles at band five and below as well as junior doctors. Senior nurses at band six and above could be worried, and in admin and clerical roles the trust has a vacancy rate of 16 per cent.

As always the trust has attempted to reassure its staff claiming all vacancies will be reviewed and those deemed essential will be recruited to.

Last month, St George’s was identified by NHS Improvement as being at risk of being placed in “financial special measures” because it was more than £2m behind its financial plan after the first three months of 2016-17.

Both NHS Improvement and St George’s will be hopeful that no serious incidents emerge linked to shortages of staff after these measures take effect.

Royal college rumble

The Royal College of Midwives has come in for strong criticism since HSJ revealed that the union had threatened an injunction against the University Hospitals of Morecambe Bay Foundation Trust to try to prevent it revealing the unusual exit payment given to a midwife at the centre of a care scandal.

On Friday, the college decided to double down, with a new statement on its website effectively arguing that the trust had breached its members’ privacy and that it was carefully considering its options.

The RCM made no reference to the fact the exit payment deal allowed the midwife, Jeanette Parkinson, to avoid an investigation into her poor behaviour. She was heavily criticised by the Kirkup inquiry into Morecambe Bay last year.

Also not mentioned by the RCM was the public interest in the trust confirming details of the leaked report given that it appears proper governance processes were not followed and Ms Parkinson received 14 months’ redundancy when she was only entitled to one month, and she also received payment for 470 hours of work that was never properly challenged.

The RCM increasingly appears to be a barrier to openness and transparency in the NHS and doesn’t appear to reflect the “putting patients first” message of the post-Francis era.