Thursday’s must read stories and talking points

Top of the league

The Department of Health is developing a league table to rate trusts on how well they report and respond to incidents and their transparency, HSJ revealed on Thursday.

The new composite rating, which is being referred to as a “learning organisation league table”, is supposed to encourage NHS trusts to investigate incidents, implement recommendations and learn from each other in a timely way.

Embedding a “learning culture” has been central to debate on how to improve safety in the NHS in recent years – at the HSJ annual lecture last year, Jeremy Hunt said he wanted the health service to be “the world’s largest learning organisation”.

But what’s good for the goose is good for the gander: as one HSJ mischievously commenter noted, would the DH, NHS England, the Care Quality Commission and NHS Improvement also be in the league table?

We’ll refrain from asking which NHS organisations are battling for a Champions League spot, and which are desperately trying to escape relegation. As another reader commented, we’re “not sure the TV deal will do that well”.

Is this the only way in Essex?

Three Essex trusts with combined revenues of around £900m are considering establishing a “single leadership team” team to run their hospitals as a “network”.

The “group model”, which would be unprecedented if it goes ahead, involves three financially challenged trusts in the Essex success regime: Basildon and Thurrock University Hospitals FT; Southend University Hospital FT; and Mid Essex Hospital Services Trust.

The rationale is that an overarching leadership team would be able to run the three trusts’ hospitals as a network more efficiently and strategically, and help address the providers combined deficits, forecast to be around £90m in 2015-16.

The legal issues surrounding the governance and accountability structure are highly complex. They are further complicated because the trio involves an NHS trust and two foundation trusts, which have different legal structures. And there are many more obvious political and practical challenges.

But now Essex is under the spotlight as part of the high profile “success regime” programme, it is likely that these plans will be pushed along more quickly than would otherwise have been the case.

This does not guarantee success, of course, but it should kick-start some action across a health economy that has been in need of reconfiguration for many years.

CCG scorecard found wanting

Jeremy Hunt has been talking about imposing a new suite of performance metrics since 2014. It has been a slow journey and his early idea for a points based system has long been abandoned. Instead, Mr Hunt announced in the autumn, CCGs would get an overall CQC style rating (as they already will, under the existing assurance regime, and a set of six similar ratings underlying this for different clinical areas.

Detailed proposals for a new assessment framework were published last week. In relation to the clinical areas ratings, which Mr Hunt said would come in June this year, the plan only commits to a “beta” version being published “as soon as possible” – suggesting further slippage. We also report that the expert chairs hired to advise on the condition level indicators might themselves decide to further slow or modify the process.

To find out why the planned high profile CCG ratings system is a bad idea, and why we think it might never happen, have a read of the first in our new series of weekly email briefings – The Commissioner.