Daily Insight: The human cost of clearing lists

The pressure to tackle long waiting lists in children’s community services is impacting care quality, with thousands of children waiting more than a year for care.

Analysis of community health services waiting list figures, published for the first time by NHS England last week, shows more than 200,000 children were waiting, of whom 12,000 had been waiting more than a year, and 65,000 more than 18 weeks.

The children’s services with the longest waits are community paediatrics, speech and language therapy, and children’s occupational therapy. Together these account for four-fifths of waits between 18 and 52 weeks.

Specialists in those areas told HSJ that the rush since 2021 to clear waiting lists’ build-up during covid was harming care quality, and that children were now presenting at more severe stages. 

Royal College of Speech and Language Therapists chief executive Kamini Gadhok warned the increased focus on waiting lists had created “a conveyor belt to get children in and discharged”.

Sally Payne, a paediatric occupational therapist at University Hospitals Birmingham and adviser to the Royal College of Occupational Therapists, agreed that “pressure” from performance managers to clear waiting lists meant “resources are [being] pulled away from some intervention approaches”, such as support groups for children and teenagers.

In with the new

Our ranking of the NHS’s leading provider trust chief executives has a clear theme this year: change. Twenty-four of the names in the top 50 are new, although some have appeared in the rankings during previous years, and we have a new number one – Angela Hillery, the leader of Northamptonshire Healthcare Foundation Trust and Leicestershire Partnership Trust.

The full list can be viewed here

Previous stalwarts of the list had moved on this year – including Sir Mike Deegan (retired), Sir Julian Hartley (now chief executive of NHS Providers), Sarah-Jane Marsh (now a national NHSE director) and Clare Panniker (now NHSE regional boss in the east).

But 19 serving chief executives have slipped from the top 50 for other reasons. The most surprising is Derbyshire Community Health Services FT chief executive Tracy Allen, last year’s number two. There was no suggestion during the judging that Ms Allen had done anything wrong, just that others were more deserving of a place this year.

Other leaders of “outstanding” trusts who slipped from the list include Berkshire Healthcare’s Julian Emms, Kingston Hospital’s Jo Farrar, The Walton Centre’s Jan Ross, Liverpool Heart and Chest’s Jane Tomkinson, and Cambridgeshire Community Services’ Matthew Winn.

A notable re-entry is East Suffolk and North Essex FT CEO Nick Hulme. Mr Hulme’s blunt style has not always found favour with the judges of HSJ’s Top Chief Executives. But his consistent and sometimes controversial record in telling it how it is as the service struggles on every front was admired by the 2023 panel, and Mr Hulme finds himself at number 16.

Read our rankings and analysis, including who our rising stars and top clinicians are, here.