HSJ’s essential round-up of the day’s biggest stories

DTOCs warning

Ministers are set to issue a fresh warning to councils deemed to have made insufficient progress tackling delayed transfers of care, amid a bitter row over the withholding of funding.

Health secretary Jeremy Hunt is due to write to around 30 local authorities. The letter will express disappointment and threaten to nationally direct how the councils use millions of pounds of social care funding next year if they do not improve.

Meanwhile, a separate but overlapping group of 20-30 councils have been threatened with the withholding of funding, potentially running into hundreds of millions of pounds, this financial year. It could be used directly by the NHS to buy care capacity instead.

The letters are expected to say councils’ share of the additional care funding pot, known as the “improved better care fund” – budgeted at £1.5bn in 2018-19 – would stay in their patch, but if they are judged as failing then the government may direct how it is spent.

It is unclear whether the letters will also be signed by a Department for Communities and Local Government.

They will be met with anger from councils, which have had big cuts to their budgets in recent years and believe an unjustified focus is being put on discharge delays at the expense of other care priorities. The Local Government Association has already condemned “the sudden and last minute setting of unrealistic and unachievable targets” for reducing delays. They have led to local rows in many areas.

Stamping out bullying

In an article almost universally described as “thought provoking” by commenters on hsj.co.uk, retired hospital chief executive Kate Grimes reflects on recognising bullying in the NHS – including in her own behaviour.

Ms Grimes, who was chief executive of Kingston Hospital Foundation Trust for over seven years, wrties: ”I was reviewing our updated ’bullying and harassment policy’ and, as the trust’s chief executive, recognised myself among the behaviours given as examples of bullying. What could be seen as the normal give and take of professional debate among a team of peers became something very different for my staff in the context of my positional power. Particularly among a roomful of their colleagues, my robust challenge could easily become an experience of being bullied. How could I credibly lead the implementation of the policy if I didn’t first change my behaviour?”

She says to “truly change the culture of bullying across the NHS” the system “must tackle the anxiety apparent in the performance management systems desperately trying to drive the delivery of national targets”.