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

The heat is on

Brexit aside, few pledges by the new government have attracted as much attention, or cynicism, as its stated ambition that it will build 40 new hospitals by 2030.

Whether the health service gets 40 truly new hospitals or a mix of new builds and refurbished facilities remains to be seen. But NHS estates leads are certainly “already feeling the heat” from Team BoJo, according to NHS England/Improvement’s estates chief Simon Corben.

If the government’s ambition is to be achieved, then trusts will need a clear and simple path to tread as they journey through the lands of business case writing, architects, design consultants, engineers and builders.

To help trusts along these expeditions, the Department of Health and Social Care is launching a six-year £20bn framework — effectively a shop — from which the NHS can buy capital services.

The new framework, called Procure 2020, replaces the DHSC’s expiring P22 framework. Under P22, six suppliers have delivered 80 major projects and 32 smaller schemes since October 2016 with an estimated value of £3.3bn.

Conor Ellis, head of health at estates consultancy Rider Levett Bucknall, told HSJ many of the 40 hospital projects would be a “step up in size” compared to most of the schemes delivered through P22.

He also predicted several new suppliers would be earning places on the framework, which is set to be split into separate regional and cost categories.

In a webinar last month, Mr Corben said “a number of projects” had gone “sideways” in the last few years, amid the capital drought and operational pressures that have engulfed the NHS.

Should Procure 2020 suffer a similar fate, then the heat certainly will be on everyone, from the prime minister downwards.

Out of touch

In a letter, seen by HSJ, the Care Quality Commission warned leaders at Sheffield Health and Social Care Foundation Trust they were “removed” from front line risk.

Trust leaders were unaware of the many high-risk practices their own staff were carrying out, the inspectors said.

The fact the practices the inspectors raised warnings about included patients receiving rapid tranquilisation without the recommended observations and children being admitted to an adult assessment ward for up to 47 hours should — one would hope — prompt the board to pay keener attention to what was going on under their noses. Concerns were also raised over a “systemic” lack of staff training and experienced staff.