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

Bravo to chiefs who spoke their minds

Expressing the view that we live in a divided, more fractious nation is a commonplace, as is bemoaning the fact that this can lead to anger and abuse. What is much rarer is a direct challenge to the discriminatory views endemic in some communities.

So “bravo” to Nick Hulme, Melanie Walker and Andrew Ridley – the chief executives of, respectively, East Suffolk and North Essex Foundation Trust, Devon Partnership Trust and Central London Community Healthcare Trust.

The three chiefs took the opportunity of appearing at an HSJ roundtable debate with fellow CEOs to declare that NHS leaders had a responsibility to “call out” racist and homophobic communities on behalf of staff and patients alike.

Mr Hulme described north east Essex as “probably the most homophobic, racist, awful place in some senses to live in the country” and said, “I’ve not heard the overt racism and homophobia that I’ve heard in Suffolk for probably 30 years”.

When challenged by his local paper on his views, he said: “I stand by my comments… We have a zero-tolerance approach to racist abuse and homophobia in our trust. This is all about protecting our patients and staff.”

Ms Walker told HSJ the county her trust served was prone to “subtle and polite” discrimination – noting the recent election of Ann Widdecombe as an MEP for the area, despite her views that there was a “scientific cure” for homosexuality.

Mr Ridley said combating racism and homophobia was “one of the few things that cannot or should not be delegated” by chief executives.

And “bravo” too to new NHS chief people officer Prerana Issar, who backed the chiefs, stating: “Leaders in the NHS are leaders in the country and therefore they definitely have a larger role [in addressing wider societal issues].”


Ian Dalton may have left the NHS for now, but he may yet have an impact from the sidelines with his new job helping the government automate public services.

The government announced on Friday that, fresh from his departure from NHS Improvement, Mr Dalton will be redeployed as executive chairman of its new automation taskforce.

Automation, getting software and/or robots to do what previously required a human, is clearly a growth area and the government wants in.

The NHS is already using automation to great, if patchy, effect in everything from processing GP referral letters (see East Suffolk and North Essex FT’s “virtual workers”) to diagnosing eye disease (see Moorfields Eye Hospital FT).

To date, automation in the NHS has proceeded with little to no involvement from Mr Dalton or NHS Improvement. NHS Improvement’s biggest role in the development of NHS digital technology has been to sign-off (or not) major trust IT investments (a power that has now passed to NHSX).

But that may be about to change, with Mr Dalton saying he was “excited about being at the forefront of this ground-breaking technology” and mentioning improving the reliability of cancer diagnosis as one area in which automation could be used.

As well as his time at NHSI, Mr Dalton will be able, perhaps, to draw upon his experience as president of global government and health for BT Global Services.

In hiring Mr Dalton to the role, Cabinet Office permanent secretary John Manzoni didn’t cite his automation know-how but how he “supported the NHS to improve their performance, improving its financial performance and ensuring the NHS is more integrated”.

If automation can help with any of these tasks, then Mr Dalton may yet have a contribution to make to the NHS.