Wednesday’s most important health stories

The best laid plans

We have revealed the all-but-confirmed configuration of sustainability and transformation plan footprints across the country in an exclusive map.

They show the geography covered by all 44 patches. There is a lot of variation in size. Among the largest, all exceeding populations of 2 million, are: Greater Manchester; West Yorkshire; Merseyside, Cheshire, Warrington and Wirral; and North West London.

Among the smallest footprints are Shropshire and Telford, and Wrekin and North Cumbria, with populations of less than 500,000.

But behind the deceptive calm of lines on a map lies ongoing gnashing of teeth over the STP project.

Plenty of patches are still debating who will be their “single leader” – or whether they will have one. Others are wondering how they will work with providers which serve and span more than one STP. Some – particularly in big patches – plan to write their STPs on smaller constituent patches, and it’s unclear whether they’ll have single shared leaders.

While people might wish they were going about their whole system planning in a different way, it doesn’t mean they’re not also optimistic about the prospects for it, and getting stuck into working out what they’ll do.

Brum on the rocks

Regulators on Tuesday issued the prestigious University Hospitals Birmingham with a strikingly critical verdict after inspecting the foundation trust’s adult heart surgery unit.

The Care Quality Commission went in after concerns were raised over the unit’s mortality rates – it was reported last week that it had identified concerns, including over safety, and that the unit would have to report its outcomes to the CQC every week.

The CQC has now published its full report. Although most of the criticisms relate to way that specific service was run, some findings pose questions for the trust’s leadership. For instance, the trust failed to act in response to repeated concerns over mortality rates. There was a bullying and blame culture in the team, and staff did not feel able to raise concerns. Plus, incidents were not always graded appropriately.

Last year the CQC rated UHB “good” overall. The trust remains one of the best regarded acute providers in the country – which makes the findings related to this specific service all the more conspicuous.

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