HSJ’s must read stories and talking points

Inpatient survey results published

Purdah has failed to stop the Care Quality Commission doing its job with its latest publication revealing details of the annual inpatient survey. Despite the worsening performance of the NHS on key waiting time targets like A&E, referral to treatment times and cancer waits, patients’ experience of the health service is holding up.

When asked about their overall experience of care, results were broadly the same in 2016 as 2015. They were asked to rate it from 0 (very poor experience) to 10 (very good experience). The proportion saying “very good” (10) increased by 1 per cent, while the CQC said the number saying very poor (0) had seen a “significant” increase on 2015, albeit remaining at only 1 per cent. The overall picture on this question was very similar to 2015.

But the report does warn of deteriorating trends which are a concern. The report said: “Whilst longer term trends are positive and indicate overall improvement, there are a substantial number of areas where results have declined in the last year (between 2015 and 2016). This is particularly around patients feeling involved in their care, waiting for a bed on a ward, and care after leaving the hospital.”

The question left to answer is where is patients’ collective red line on NHS performance? Of the evidence of the survey, it seems it was not crossed as of 2016.

NHS England in the dock again

NHS England could well save costs by maintaining a regular presence at the High Court. In the past 18 months it has lost a number of judicial review cases focused around its specialised commissioning decisions. HSJ has reported that once again the commissioning body has found itself on the losing side, with two separate decisions against it following a refusal to prescribe a drug to a seven-year-old boy with a rare genetic condition.

The reason for the two defeats were entirely of NHS England’s own making. Having first tried and failed to argue that the boy was not an exceptional case, NHS England changed its stance and instead accepted the boy was after all, exceptional. Its new grounds for refusal was that the drug, Kuvan, was not proven to be clinically or cost effective. Lawyers for the family went back to the High Court last week and successfully won permission for a new judicial review against those decisions.

The case could have far reaching consequences. The family’s legal team are arguing that NHS England may have breached its duty under the Children’s Act and human rights legislation. If they win the decision could create a new duty on NHS England when its commissioning services for children. The judicial review will be heard in July.