HSJ’s roundup of Monday’s most important stories and analysis

Falling short

HSJhas revealed further evidence of the strain on NHS hospitals trying to ensure their wards have enough nursing staff.

Our analysis of 225 hospitals sites in England has found more than nine out of 10 are failing to meet their own targets for the numbers of nurses working on wards.

In total, 92 per cent of hospitals failed to meet their planned nurse staffing levels during that day, with 81 per cent of hospitals failing to have enough registered nurses working at night.

HSJ was told by some nursing directors they were struggling to recruit nurses and the likes of Royal Wolverhampton Hospitals Trust are going overseas to find as many as 200 nurses.

Other nursing directors said they supported the new agency cap to try to bring nurses back into substantive roles but Chris Hopson, chief executive of NHS Providers, told HSJ there was a lack of ”clarity and consistency” from the centre about how trusts should balance demand for nurses against the financial pressures on the system.

The data suggests trusts have seen their performance against planned staffing levels worsen compared to 2014, but it could also be the case that many hospitals have increased their staffing levels in the wake of the Francis report and NICE’s guidance on staffing in acute wards.

Our findings come at a time of a nursing shortage, meaning it is currently much harder for trusts to meet their increased staffing plans.

Bad trips 

The Care Quality Commission’s hospital inspection directorate spent £4.4m on hotels and travel last year against a budget of £1.1m.

The regulator said the overspend occurred because its budget was based on its previous, lighter touch inspection regime, and that the budget was increased in 2015-16 accordingly.

However, in the first half of this year the hospitals directorate was already almost £700,000 over its “travel and subsistence” budget.

The revelations come at a sensitive time for the watchdog because under the government’s plans the CQC will soon have to cover its costs through fees charged to those it regulates.

Can you see devolution from space?

On Tuesday, the Cities and Local Government Devolution Bill reaches the committee stage in the House of Commons. If the bill became law, it would give ministers wide ranging new powers to transfer NHS functions, funding and assets to councils.

HSJsenior correspondent David Williams and Nuffield Trust policy analyst Mark Dayan have looked at what impact this ”reconstruction of the English state” would have on the health service.

David also posted some of his observations about this imortant bill on Twitter on Monday: