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

The NHS already performs poorly on early cancer diagnosis – that the Windrush scandal may have worsened this for black-British people is a whole other scandal.

The wrongful deportation of people from the Windrush generation and the “hostile environment” policy run by the Home Office until quite recently were always going to discourage people from using services.

West Midlands Cancer Alliance noticed this last year, as the first wave of covid was subsiding, but the NHS should have planned for this consequence at a higher level.

The West Midlands isn’t the only place in the UK where people might have avoidably died because people were afraid the NHS was going to share their data with the deportation teams.

And up until 2018, that is what NHS Digital was doing.

What might have felt like a niche data-governance issue to some was actually a critical trust issue for communities that the NHS disproportionately fails to treat in time.

Data out last week showed the covid effect on cancer services hit the treatment of people from ethnic minorities harder and performance took longer to recover.

Trying to address vaccine hesitancy among staff also gave some senior managers a crash course in recent scandals that create mistrust – Pfizer’s experimenting on children in Nigeria, being an example.

The good news is that by the end of 2020 treatment rates for ethnic minority communities had caught up with 2019 levels. The bad news is those levels are still too low because the health system is underfunded.

Failing to learn

The abusive cultures which can develop within private inpatient mental health hospitals has been a long-running theme over the past few years.

Time after time, HSJ has published reports from the Care Quality Commission exposing concerns over the care within these “isolated” units, as the regulator has previously described them.

This week the CQC has exposed concerns at a hospital called Broomhill, run by private provider St Matthew’s Healthcare. The report covers allegations made by patients over staff assaulting them and a lack of compassionate care. Patients speaking with the CQC reportedly described the unit as “the worst hospital they’d been in”.

Those reading the report could be forgiven for thinking they were reading the report published last year into the same organisation.

In May 2020 the CQC published an inspection report which reads almost identically to the report published this week, with patients alleging staff had assaulted them. What is clear is the provider has failed to sufficiently address and take hold of the poor culture that had developed within the unit.

The wider question of how these cultures develop in the first place is a complex one. During one recent session by the health select committee it was suggested that they develop because of the “institutional” nature of mental health inpatient units. Prior to this the CQC argued that often independent mental health units are “isolated”, which enables poor care attitudes to be fostered.

Both are perhaps true. However, neither excuse the failure of this organisation to have made such little progress in addressing the CQC’s concerns from last year.