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

Trust seeks £300m to plug Carrillion black hole

It is nearly eight months since construction firm Carillion came to an abrupt end, but the knock-on effects on the NHS remain prevalent.

While the trusts with FM services formerly carried out by the company have moved on, the same cannot be said for two trusts expecting new hospitals to be built.

Carillion’s demise has caused huge headaches for both trusts, the lenders, and the government – which has not yet decided on a suitable cause of action for either projects.

One HSJ reader cynically remarked that a solution may have been found more hastily had either of the new hospitals been situated somewhere inside the M25 with a “sexy postcode”.

While a privately financed solution has not been ruled out for Liverpool’s new hospital, the Sandwell and West Birmingham Hospitals Trust has now decided it wants a publicly funded deal to finish its Midland Metropolitan Hospital.

The capital ask is £319m (or thereabouts), which would take the hospital at least £150m over budget overall.

The business case for this now sits with NHS Improvement, the Department of Health and Social Care, and the Treasury, but it is not clear when a final decision will be made.

In the meantime, the trust faces the unenviable challenge of reconfiguring its acute services for the two-year delay to the new hospital opening.

This will also cost money, and is another chunk of cash the trust is seeking from the centre.

Delays in answering 999 calls may have led to two deaths

A shortage of ambulance control room staff, which left 999 calls unanswered for up to 10 minutes may have led to the deaths of two patients, HSJ can reveal.

South East Coast Ambulance Service Foundation Trust investigated 10 serious incidents related to call answering delays in 2017-18. In eight of these cases, the patients died, either at the scene or later. After investigation, two of these deaths were categorised as directly related to the trust’s involvement.

In one of the 10 cases, the parents of a three week old baby called 999 but the call could not be answered in the nearest emergency operations centre. The parents started to drive the baby to hospital and flagged down an ambulance on the way: the child died shortly after reaching hospital.

In another case, a call for a patient who was not breathing took seven minutes to answer: when a paramedic reached the patient they could not be resuscitated.

One serious incident report says a 999 call was put on hold for 10 minutes before being answered.

NHS on alert

NHS organisations have been sent an alert from the chief medical officer following news that over 20 trusts were sent a suspicious package containing an unknown liquid.

The Met Police confirmed today that two men were arrested yesterday evening in North London on suspicion of Malicious Communications Act offences.

The alert informed all NHS organisations that counter terrorism policing are managing the response and forensic testing is currently underway on the substances received by the hospitals.

Sally Davies has also issued guidance on what to do, which include wearing nitrile gloves and quarantining the package in a secure leak-proof container.

Internal NHS emails seen by HSJ reveal a note was included in the package sent to Milton Keynes Hospital that said it was from a Mr Iraj Mohebbi. It also stated that similar samples have been sent to 25 other trusts.

The Met Police confirmed that investigations are still ongoing.