The must-read stories and debate in health policy and leadership.
As nascent integrated care systems make their journey towards statutory footing next year, questions have arisen over how their new-found status can shape the system.
The Care Quality Commission’s chief inspector of hospitals firmly believes ICS leaders should focus on quality and safety as their main priorities.
Speaking at HSJ’s Patient Safety Congress, Ted Baker urged them to not “go down the NHS path of focusing on financial and operational targets”.
He said: “It’s often taken really courageous leaders to put quality first ahead of financial targets and operational targets… You have to be courageous to do that and I think some of the leaders of the ICSs, they need to be that courageous.”
Professor Baker added: “If we can do that, we can have a really transformative effect on integrated care across [the] system. I suppose that’s what I’m asking for: courage from all of us to tackle some of the cultural issues in the NHS.”
While the chief executives of these fledgling ICSs will have their work cut out for them, the firm words of the CQC’s outgoing chief inspector of hospitals might reverberate for some time.
The question is how they will tackle their new priorities.
The full extent of pressures on the NHS rarely gets into the open and it might be easy for many people to imagine that, with covid hopefully past its peak, many services have returned to near normal.
A group of consultants from Brighton destroyed that illusion with a letter to Brighton and Sussex University Hospitals Trust chief executive Dame Marianne Griffiths, detailing some of the problems they face.
Urgent aneurysm repairs and cancer operations were being repeatedly delayed due to staffing issues, they said, together with delays to time-critical emergency and trauma cases creating “an extremely unsafe situation”.
Staff were “trapped” at work as operating sessions ran late and anaesthetists were forced to look after patients in recovery, meaning other procedures could not start on time.
Most devastatingly of all, they questioned where it was safe for the Royal Sussex County Hospital to remain open as a trauma tertiary centre. The trust acknowledged many of the pressures described and said it as redeploying staff – and had increased pay rates for extra hours.
Another problem created by covid? Although some of the staff exhaustion and reluctance to give up their leisure time to do extra shifts will be due to their experience over the last 18 months, there seems to be something more underneath this.
The consultants’ letter points to staff being willing to work in private hospitals because conditions there are better and there is also the impact of the high cost of living in Brighton. Staff – especially nurses – may simply be finding the rewards of working in the NHS are simply not worth it for the pressures involved.