HSJ’s roundup of Tuesday’s must read health stories

Get ahead of Carter

There are high hopes resting on the review of NHS efficiency by Lord Carter, with health ministers quick to reference it when asked about sorting out the financial mess in the acute sector.

But after more than a year of working up new metrics, there appears to have been little progress in creating an adequate measure of overall trust efficiency.

Although trusts are able to challenge and negotiate their savings targets, and other data is taken into account in these discussions, there was certainly an expectation among some finance officers that the work would be more advanced after more than a year.

The headline savings estimates sent to hospital trusts in recent weeks are based purely on contentious reference costs data, which have long been collected nationally.

There are longstanding concerns about the use of this data, and a recent audit found nearly half of trusts had submitted figures that were “materially inaccurate”.

HSJ was able to broadly replicate the methodology used to produce the headline measures, using the publicly available data, and has compiled the data for every acute trust.

Lord Carter himself has been reluctant to attach detailed savings targets to his work, and finance chiefs appear to welcome his collaborative approach.

But there is now anxiety about how his findings will be used by the Department of Health and/or NHS Improvement, and how closely they will be tied to bailout funding.

Hunt’s knight in shining armour

Following his well received review into how to reform the provider sector, Sir David Dalton has again been called upon by the health secretary for an unenviable task.

Jeremy Hunt has asked the Salford Royal boss – with NHS Employers chief executive Danny Mortimer – to head up negotiations between the British Medical Association and the government, through Acas, over planned changes to the junior doctors contract.

Three periods of industrial action this month and next were announced by the BMA on Monday evening, after no agreement was reached with the government during the last round of talks.

In a letter published on Monday night, Mr Hunt praised Sir David’s “strong track record in the field of quality improvement with a focus on patient safety” and “reputation for engaging with staff”.

But two further letters show the size of the challenge facing David and Danny.

Mr Mortimer gave his take on why the talks collapsed, saying progress had been made on “all points of substance, with the exception of pay” and the BMA needed to further explain its own pay proposal.

Meanwhile, BMA junior doctors committee chair Johann Malawana said the latest contract offer was a “misrepresentation of what we believed to be the current position”.

Sir David now has the job of building bridges where no one else has managed so far.