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

The only people who really know how good the care is at a hospital trust are the staff delivering it.

Execs should have an idea but don’t always, external regulators have even more difficulty. (Former Care Quality Commission chief inspector Mike Richards had to advertise his mobile number so staff could raise issues with him without being spotted and ostracised by colleagues).

So the results to the question in the anonymous annual staff survey about whether they would be happy for a friend or family member to receive the standard of care provided by their organisation are important.

Nationally the proportion of staff who agreed fell from about three-quarters to about two-thirds.

Worrying, but maybe not unexpected during the most punishing covid years so far.

More concerning was the growth in trusts where a majority of staff would not recommend care there. That total rose from one in 2020 to eight in 2021.

The survey showed some very steep declines year-on-year though. The North West saw two trusts record drops of more than 144 percentage points on this measure.

Conversely, London trusts performed well, seeing smaller falls. The capital’s performance might be down to a higher number of students able to take up some of the strain. The capital’s trusts also have more consultants on joint contracts with universities, meaning a greater flexibility in how they responded.

Still free to park… for now 

Early in the covid crisis ministers pledged to fund free parking for NHS staff for the duration of the pandemic.

As HSJ reported, Sajid Javid announced last week that the arrangements would end as part of wider “living with covid” measures. 

But some trust and system leaders, looking at ways to help staff with the cost of living and others with little alternative because they only learnt about funding ending late in the day, have opted to meet the costs of maintaining free parking out of their own pockets.

Two ICSs covering more than 10 trusts are extending free parking for an initial three-month period, while individual trusts have also opted to keep waiving the fees.

Although the cost of plugging the income gap is small in NHS terms, one CEO told HSJ they were worried that they would be reprimanded for keeping parking free if they missed their financial targets. Unison’s deputy head of health, Helga Pile, said re-introducing parking charges was “wrong” when staff were still waiting on “their already overdue pay rise”.

Also on today

Get up to speed with health news and views from the rest of the media in The Primer, and in North by North West, Lawrence Dunhill looks at the unusual situation which has seen The Christie cancer trust snub NHS England’s request to apologise to whistleblowers.