HSJ’s roundup of Friday and the week’s most important stories
- Today’s must know: New DH permanent secretary appointed
- Today’s talking point: Solve deficits and protect patients or face suspension, Hunt warns boards
- Today’s risk: It will take “a long time” to gain whistleblowers’ trust, says national guardian
Sort finance and quality – but make sure you sort finance
NHS providers were on the receiving end of a string of strong and important messages from the centre on Friday. “Coordinated” may be a generous adjective for these communications from Jeremy Hunt, NHS Improvement and the Care Quality Commission, but the sequencing – and timing running into the weekend – is worth noting.
Here’s how it unfolded:
- Midnight: A media announcement from the health secretary is published, restating rules under which access to a £1.8bn central funding pot in 2016-17 will depend on hitting savings targets – and upping the ante by saying that NHS providers which “balance their books without compromising patient care” will face intervention which could ultimately “result in the entire board… being suspended”. While this rhetoric may please those in Whitehall responsible for public spending, and definitely got healthcare leaders’ backs up, such action is highly unlikely to happen in many places – there are not enough replacements around, and NHS Improvement will have to support rather than undermine providers if it wants to succeed.
- 11.40am: Chief inspector of hospitals Sir Mike Richards and NHS Improvement chief executive Jim Mackey write to providers promising they will work more closely together in making their judgements on finance and quality and to tell them there need be no trade-off between funding and quality – declaring: “Your task as provider leaders is to deliver the right quality outcomes within the resources available”. This positive message appears to be a particular shift for the CQC – could it mean giving NHS Improvement a role in its critical judgements on things like leadership, as well as use of resources?
- 6pm: NHS Improvement sends a 10 page letter to NHS providers, including a clear ultimatum if they want to access their part of the £1.8bn “sustainability fund”, which is aimed at eliminating the provider overspend next financial year. This guidance has been keenly awaited, but finance directors perhaps weren’t expecting to be given just three weeks and a demand to sign up to a specific control total for 2016-17 in order to get their share.
In paragraphs likely to be of more interest to users of the health service, the letter also revealed a number of eye catching measures to cut costs in the next two and a half months, including work with some providers to reduce staff headcount, and asking providers to delay holiday and not cover sickness absence. “This letter sets out what your board must urgently do during the remainder of the 2015-16 financial year,” it states.
It is hard to avoid the feeling that it is the 6pm letter - buried on Friday evening and with the day’s earlier announcement providing some cover - which is intended to cause chief executives the most angst in coming weeks.
Guardian faces up to blowback
When Dame Eileen Sills was announced as the new national guardian for NHS whistleblowers last week, she received a bit of a rough ride on Twitter and below the line.
The news that she would be doing the role two days a week while still holding down her job as chief nurse at Guy’s and St Thomas’ Foundation Trust attracted particular criticism.
However, in an exclusive interview with HSJ and our sister title Nursing Times, Dame Eileen defended the decision. She said maintaining a link to the frontline (she does a clinical shift at Guy’s once a week) gave her and the national guardian’s office “credibility”.
She also promised to do both jobs “in the hours it takes me to do it” to make the national guardian role a success.
While Dame Eileen told HSJ she had never viewed herself as a whistleblower, she said she had worked in environments where she felt unable to speak up and had even been labelled “an agitator” during her 35 year NHS career.
With some negative comments still swirling around on Twitter from vocal campaigners, Dame Eileen’s comment that it will take “a long time” for her office to build up trust is surely on the money.
Ten more must reads this week
- New DH permanent secretary appointed
- Maidstone trial: Patient’s death ‘wholly avoidable’, court hears
- Analysis: NHS corporate manslaughter case puts spotlight on systemic errors
- Dalton: government ‘muddled’ seven day services message
- Strike analysis: Breakdown in trust could take years to repair
- NHS leaders’ fears over costs of new deal for doctors
- CCG allocations: winners and losers revealed
- Virgin Care wins Kent community contract
- Head of huge procurement partnership ‘no longer a director’
- Better care fund £1bn payment for performance scheme axed