The must read stories and talking points from Thursday

Look who’s talking

There was another plot twist in the continuing saga of the junior doctors’ contract dispute on Thursday, as medical royal colleges made good on their widely expected intervention to try to bring the government and BMA together.

Rather predictably after a day of statements, stories and responses to earlier statements, we appear no further forward.

The government initially said it was too late to stop the imposition of the new contract. Then the Department of Health changed tack and told the BMA that it would suspend the imposition for five days and talk to the union, but only if the BMA would commit in writing to discussing the issue of Saturday pay.

Throughout the dispute the government has wanted to increase the amount of Saturday hours paid at plain time rather than at an out of hours premium.

The BMA has always resisted this and insists doctors working weekends deserve recognition (the government says it will recognise this with a higher basic salary for all doctors).

The BMA responded to the government but did not mention Saturday pay.

HSJ sought clarity and was told by a spokesman that the BMA would suspend strike action and was “going into these agreements without preconditions”, but then added: “So [we] cannot say if we’ll discuss weekend pay.”

The DH took no time in replying to that position: “We were clear in our letter that we are expecting the [BMA] junior doctors’ committee to give a written assurance around discussing weekend pay.”

So it looks unlikely at this stage any meaningful progress has been made. Friday may bring further clarity.

‘Remarkable’ rating for Northumbria

As HSJ readers will be aware, NHS Improvement chief executive Jim Mackey used to be the boss of Northumbria Healthcare Foundation Trust.

Mr Mackey left Northumbria to lead the new super-regulator last November – just when the Care Quality Commission dropped in to inspect the North East trust.

The resulting CQC report, which was published on Thursday, will not cause the NHSI chief executive any embarrassment – Northumbria is the fourth trust in the country to receive a coveted outstanding rating.

It’s difficult to identify “the best trust in the country” on the basis of CQC ratings because the regulator rates trusts across a number of domains and across various levels. Still, the chief inspector of hospitals, Sir Mike Richards, commented that Northumbria getting an outstanding rating across 20 core services was “remarkable” and “a first” for the health service.

When HSJ spoke to David Evans, Northumbria’s new chief executive, he said the glowing inspection report was down to strong clinical accountability and a quality orientated culture – a familiar theme from chief executives of outstanding trusts.

Northumbria hasn’t been afraid of making potentially controversial changes – last year it centralised services to a new specialist emergency care hospital, and Mr Evans urged other NHS leaders to “grasp the nettle” on tricky reconfigurations.

However, anyone who follows that cue should also prepare to be in it for the long haul. His other bit of advice on how to deliver a successful reconfiguration? “Start 15 years ago.”