HSJ’s roundup of Thursday’s key stories

NICE scalded for flip-flop

HSJ readers have responded passionately to the news that NICE will now not publish its safe staffing guidance for emergency departments.

NICE had previously announced it would publish its finished work on safe nurse staffing levels in accident and emergency on its website this month, along with four evidence reviews of safe staffing in other settings.

However, it has now said it will not make the information available to avoid pre-empting future work on safe staffing by new regulator NHS Improvement.

A source within NICE told HSJ it had come under “pressure” from NHS England and the Department of Health not to publish the information on its website because of fears it would become de facto official guidance that NHS trusts would feel compelled to follow.

The DH poured cold water on that version of events, calling it “nonsense”. In a statement, it said: “Existing draft work on safe staffing will be published by NHS Improvement as part of a package of supporting evidence for new guidance.”

One reader thought NICE has been “bullied”, while another described the situation as “farcical”. One theory was: “The simple reason why the information is not being published is because the government believes it can’t afford to support what the guidance says.”

HSJ believes not publishing the guidance now is a bad decision for a number of reasons and has called on NICE, NHS England and the DH to release it without delay.

England’s first ACO?

A clinical commissioning group is proposing to hand its budget and nearly all its functions to a provider led “accountable care organisation”, in what may become a first in the NHS.

Those working on the move, which will be the subject of discussion in the area over coming months, told HSJ it would represent a very substantial reduction of Northumberland CCG’s functions, and a substantial move away from the current commissioner/provider divide.

The proposal is part of the health economy’s work to overhaul its models of care and contracting. It was one of the 29 national vanguard sites identified in March and is developing a primary and acute care system.

People are impressed with the ambition on show. “Clever stuff this. By removing the internal market locally, the year on year debacle of contract negotiations will be avoided,” commented one reader.

Smith review (finally) published

The new regulator NHS Improvement will develop a national succession programme for the top 200 provider and commissioner leadership posts in the NHS, including establishing a talent pool. The new regulator will have to identify which roles are the most in need of a clear succession plan - an important task given recent churn at the top of the service.

The plan is one of the major recommendations of the review of centrally funded leadership and improvement functions – widely known as the Smith review after NHS England deputy chair Ed Smith who led it.

The review lambasts the existing arrangements for system improvement, calling it “remote, fragmented and unclear”.

However, some of the review’s recommendations have been overtaken by subsequent announcements by the health secretary.