HSJ’s round-up of the day’s must read stories and debate

Overthrowing the hierarchy

The “second-class citizen status” of NHS staff who do not have clinical roles must be addressed urgently, an HSJ inquiry has concluded.

The HSJ/Serco Inquiry on Maximising the Contribution of NHS Non-Clinical Staff said that the work undertaken by more than half a million NHS workers is too often hidden, leading to a “divisive” hierarchy which has a negative impact on both the service and the patients it treats.

The inquiry, published on Monday, concludes that the work of those in areas such as IT, facilities and estates should be championed at board level by non-executive directors, while HR departments and unions also have a role to play in making sure their voice is heard more loudly within the NHS.

Doctors, nurses and others in clinical roles are also asked to avoid the common practice of being complimentary about clinical colleagues while regarding others in support roles with “disdain”.

The arrival of the accountables

The Commissioner’s analysis of STPs published as far as last Wednesday found the most widespread topic was plans to expand and develop community-based services

Dave West wrote: “STPs draw most heavily on less buzzy community based changes which have been the subject of NHS strategies for a long time: Neighbourhood/30,000-50,000 populations; multidisciplinary teams including social care; risk stratification and case management; primary care centres or networks with extended access; step-up/step-down care; overhauling outpatients. There are a few new acronyms for this concept (see south east London’s LCNs) in STPs but I’ve seen few convincing, dated commitments to full blown MCPs, PACS or ACOs.”

There has been a hearty attempt to disprove that by a couple of the STPs which have arrived since: Somerset proposing to create an “accountable care system”, and plans to spread “accountable care organisations” and the like, willy-nilly across West Yorkshire.