HSJ Catch Up: A&E targets, 'worrying' staff surveys and Dido's job interview

David and Jim’s pep talk

After some local NHS leaders were urged to chant “we can do this” and improve accident and emergency performance, some more sedate – but significant – encouragement from Sir David Dalton and Jim Mackey.

In an exclusive article on hsj.co.uk, the Salford Royal/Pennine Acute chief executive and NHS Improvement boss have told hospital leaders not to neglect the four hour A&E target and to be “vigilant about the patient’s experience in your ED”.

HSJ editor Alastair McLellan observed that the intervention shows how worried the centre is that trusts are giving up on the target as impossible.

Sir David and Mr Mackey write: “Some people have said that the four hour standard is no longer relevant. We don’t agree. Meeting the four hour standard in our emergency departments is a patient safety issue…

Sir David has also joined the debate over NHS pay rises, after Jeremy Hunt said any new deal would be “linked to productivity”. Writing underneath our story over the weekend, Sir David said: “Rather than just rely on some high level, productivity indicator for the NHS, we should consider creating a link to the contribution of an individual or team to the goals and values of their employing organisation. Many organisations in many industries are able to manage an assessment process which reviews not only ‘what’ people have done but also ‘how’ they have done it. Delivery of objectives and behaviours are then given equal importance.”

• Dalton rules himself out of NHS Improvement chief executive job

New NHSI chair’s job interview

The new NHS Improvement chair, Baroness Harding, faced MPs on Tuesday to be interrogated at a pre-appointment hearing.

The former TalkTalk boss was challenged on the company’s handling of a cyberattack in 2015. She said she was criticised for speaking out early (“I’ve been a pretty big thorn in the side of ministers who didn’t like what I was saying”) but this was the right thing to do for customers – and if the situation happened again she would want to speak out even earlier.

The baroness, who is a Conservative peer and married to MP John Penrose, was also asked about her political connections.

She had some thoughts on the type of person who should follow Jim Mackey as chief executive. They must have experience of running big organisations and need to be a “superwoman or superman… steeped in the service”.

Maybe there’s still a place for heroic leadership in the NHS after all.

Trust faces third prosecution

A third prosecution will be brought against Southern Health Foundation Trust after a patient was found dead in a hospital in Southampton five years ago.

The Health and Safety Executive is taking action against the trust over the death of Teresa Colvin on 22 April 2012. Ms Colvin died at Woodhaven adult mental health hospital.

An HSE spokesman said the trust is being prosecuted under section 3 (1) of the Health and Safety at Work etc Act 1974.

Last week, the trust was fined £125,000 after a Care Quality Commission prosecution over safety warnings that were repeatedly ignored by the trust.

Southern Health has also pleaded guilty to breaching health and safety law over the death of Connor Sparrowhawk in 2013.

Staff have their say

HSJ has published details of NHS England and NHS Improvement’s previously uncirculated staff survey results. The surveys were conducted last year, and requested under the Freedom of Information Act in the spring.

We’ve only published the results now because getting NHS England’s figures released took rather longer than the 20 day statutory limit for FOI replies – the results were only released after Simon Stevens received a threat of contempt of court proceedings from the Information Commissioner’s Office.

The results are a mixed bag for NHS England, and pretty depressing for NHSI.

NHS England’s results were in line with the wider service on bullying and discrimination, for example, and its overall staff engagement score was rising.

A comfort for NHS England is that its results were not as bad as the Department of Health’s.

NHSI’s scores reflect an organisation unhappily undergoing a merger: staff reported poor communication, a lack of vision from senior leaders, a widespread intention to work somewhere else, and low levels of pride in their organisation.

Something to bear in mind next time someone suggests merging NHS England and NHSI.

No winners in DTOCs feud

Poor progress on delayed discharges is a source of great angst at the top levels of both government and the NHS – despite councils being allocated an extra £2bn over this year and next.

As we revealed this week, ministers have threatened to cut next year’s funding allocations for 32 councils whose delayed transfers of care performance has been deemed especially poor.

The mess the system finds itself in was entirely predictable. NHS Providers warned shortly after the funding was allocated in the March budget that councils would use the cash to fill existing holes in their services (somewhat understandably given the cuts inflicted on councils since 2010) rather than on speeding up discharges.

NHS England told acute providers to “get lippy” with their local government counterparts to influence how the money was spent. But it is worth remembering it was Simon Stevens who in June 2016 called for any money available for health to go to social care rather than the NHS, to address delayed discharges.

With the latest figures showing A&E performance on a downward trend, ministers had better hope that other warnings – like Chris Hopson’s of a “winter of discontent” – don’t come to pass.