HSJ’s round-up of Monday’s must read stories

CCGs’ lack of strength

It’s time for “top-down reorganisation” of clinical commissioning groups, argues HSJ editor Alastair McLellan in an editorial published on Monday.

He writes: “The creation of [sustainability and transformation plans] stems from a clear eyed recognition by NHS England that clinical commissioning groups are unable to fix the underlying problems affecting most health economies.

“In other words, the bodies created at great expense and even greater opportunity cost four years ago are not fit for purpose in the eyes of those responsible for their stewardship.”

He also states that “many CCGs are not strong”, and it has been a challenge for every CCG to find good quality chairs, accountable officers and finance directors – “which is why you end up with a tiny and struggling CCG spending £500,000 on two interim directors”. Others, such as on the South East Coast, are struggling to have an impact because of their small size.

NHS England is due to publish a long awaited CCG “roadmap” in the autumn. One thing it must have, the editor says, is “an unambiguous recognition that CCG ‘merger’, formal or otherwise, will now often speed the introduction of new care models and other reforms”.

Nursing voice weakened

In 2013 Sir Robert Francis warned of the lack of a strong nursing voice in the NHS and said this needed to be strengthened.

Fast forward a few years and the chief nursing officer has been moved out of Richmond House, and late on Friday HSJ revealed the Department of Health’s own nursing policy unit is to be scrapped.

This is all part of the “DH 2020” cost cutting drive to reduce its running costs by 30 per cent and lose 700 posts.

The proposal will mean the departure of seven staff including director David Foster.

Also affected will be the DH’s adviser on mental health, Ben Thomas; nursing and midwifery adviser Jean Christensen; and allied health professions adviser Alison Raw. Three support staff have also been formally told their roles are at risk of redundancy.

The decision has been condemned by unions and many nurses on social media, who say it speaks to the view of nursing as a profession by the government and underlines the fears Sir Robert raised in 2013.

A DH insider told HSJ this would seriously affect the quality of advice to ministers: “If you have internal professional staff helping policy teams with advice then you get adherence to the civil service code which is about impartiality, objectivity, honesty and integrity.

“If you rely on people outside the department you might get their partial, biased opinions with no evidence and balance. Ministers will ask for the answers they want rather than the breadth of balance they should have.”