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

Inadequate again

The pain continues for one of the West Midlands’ most troubled providers, with the Care Quality Commission rating the organisation inadequate again.

Worcestershire Acute Hospitals Trust has been struggling on many fronts (finance, quality, governance) for years, but there had been hopes that a new chief executive, Michelle McKay, was making some headway.

The regulator, in its second report in less than six months, did find some areas of improvement (leadership, maternity), but overall the trust remains a mess.

Some areas, specifically general surgery, had deteriorated further since the last inspection, and the CQC stressed that efforts to improve needed to move faster.

The report reveals an organisation with crowded emergency department corridors, thousands of patients waiting unacceptably long periods for surgery, and leadership without a clear view of the organisation’s problems. 

Ms McKay has said estates projects at Worcestershire Royal Hospital (including 30 new beds) this year will help. But it will take more than some extra space (even with a commensurate rise in nurses) to turn around years of poor performance.

Sainsbury muscles in

A new think-tank backed by Lord Sainsbury (of supermarket chain descent) has muscled into the healthcare arena with a hard-hitting report that highlights differences in mortality rates linked to the financial performance of NHS trusts.

Researchers from the Centre for Progressive Policy have identified 32 “risk zones” where people are more likely to die of preventable causes.

The areas all have low levels of life expectancy as well as an NHS trust which is in financial trouble.

The researchers found a “strong tendency” for a trust’s performance in the three core standards to weaken as financial position worsens, as well as a “strong link” between underfunding and the number of safety incidents reported.

The thinkies have been supported by an advisory group including Dame Julie Moore, Professor Mike Bewick, and Sir Ian Gilmore, and now plan to undertake a year-long programme of research and engagement to come up with a “truly sustainable, high quality system of health and social care”.

An admirable ambition, but it sounds tricky.

More scrutiny for private hospitals

As the private sector continues to face scrutiny over the safety of its services, HSJ has revealed today the tragic death of 28-year-old who died after surgery at a BMI hospital in Croydon.

Michael Battersbee died after undergoing surgery he should never have had in the private sector. He was referred by the NHS for treatment of an epigastric hernia but he also had obstructive sleep apnoea and a high body mass index. Both should have ruled him out of private surgery under the NHS standard contract at the time in 2015.

His family are now taking legal action against BMI Healthcare after a coroner last year issued a prevention of future deaths report and criticised BMI Healthcare processes which meant Mr Battersbee was not perioperatively assessed before surgery and during the operation had insufficient ventilation.

He died in recovery when the anaesthetist that was looking after him was left “alone and unsupported.”

Health secretary Jeremy Hunt has recently called for the private sector to get its house in order on quality and safety, and the death of Mr Battersbee, a father-of-three, gravely underlines the point.