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

The retirement announcement from Trish Armstrong-Child, of Blackpool Teaching Hospitals, has come as a surprise to many in the Lancashire health system, after some improvements were starting to show at the long-troubled acute provider.

She says it was a purely personal decision to spend more time with her family, and there’s no suggestion of anything else at play.

Some senior sources did, however, express concerns at how difficult things have become in Lancashire and South Cumbria, given the financial pressures.

They said Blackpool initially submitted a draft plan for a deficit of more than £70m for 2023-24, but was eventually strong-armed by system leaders to cut that to £24m.

The details of those negotiations are unclear, but it sounds like they were far from smooth, and various non-executives with extensive private sector experience, including chair Steve Fogg, were left aghast by the whole process. Mr Fogg had been re-elected as chair in September, but resigned in November, when trusts had to resubmit their plans for the fourth time. Non-executive directors Carl Fitzsimons and Mark Beaton also stepped down in the latter half of 2023.

On top of this, the system is driving hard and fast on a programme to consolidate a raft of corporate and back office services across its trusts, which is creating plenty of anxiety and tension within trusts’ headquarters.

As one senior source put it: “Why would you want to stick around for that?”

CQC ranks maternity sliders

The Care Quality Commission has revealed the trusts where maternity care has witnessed the most significant decline, according to patient surveys.

In February 2023, the regulator gathered feedback from 25,515 patients across 121 trusts regarding their experiences spanning antenatal care, labour, birth and postnatal care. It pinpointed areas where care experiences markedly differed from the national average across all trusts in England.

The survey depicted a national downturn in maternity care, with responses to 11 questions indicating a statistically significant decline compared to five years earlier. Five trusts were flagged as “worse than expected,” reflecting notably subpar patient experiences:

  • University Hospitals Birmingham Foundation Trust, fluctuating between “inadequate” and “good” maternity ratings;
  • The Dudley Group FT, rated “good” for maternity;
  • Ashford and St Peter’s Hospitals FT, rated “inadequate” for maternity;
  • Bolton FT, rated “requires improvement” for maternity;
  • Mid and South Essex FT, rated “requires improvement” for maternity.

Leading in scores were Royal Surrey County Hospital and Northumbria Healthcare. Despite past criticisms, University Hospitals of Morecambe Bay also displayed notable improvement. Last year’s sole “much worse than expected” rating for Dudley Group was absent in the 2023 survey.

Also on today

The sharp focus on ambulance handovers and the need to speed up hospital discharges as a result has begun to pose existential questions for the two remaining community trusts in the North West, writes Lawrence Dunhill. And we report that an acute and community trust in one of the country’s most challenged systems has announced a replacement for its long-serving chair.