Your essential update on health for the week

HSJ Catch up

This weekly email gives HSJ subscribers a vital update on the biggest stories from the last week in health. If you have been out of the office or otherwise just too busy to keep up, HSJ Catch up will ensure you are still in the know.

Wintery scene

December emergency department four hour wait performance was spared from being the worst ever recorded only by rounding off figures. At one decimal place, the all department score equalled last January’s of 85.1 per cent – the previous all time low. At two decimal points, however, only 85.07 per cent were seen within four hours last month; last January it was 85.14 per cent.

Looking at performance in only type one (“major”) departments paints an even rougher picture. This was worse than in last January. Examining trusts’ individual performance, 18 achieved 90 per cent or above on type one attendees – down from 31 in the previous December. The shining examples of those able to defy gravity are dwindling.

And HSJ has revealed a remarkable letter to the prime minister, signed by clinical directors of more than 60 UK emergency departments.

Hunt stays put

So, after the speculation and longer than expected wait for news, Jeremy Hunt not only stays as health secretary but has expanded his job.

Mr Hunt had been rumoured to be the next first secretary of state (effectively the deputy prime minister) and there was talk he could become business secretary. Instead, he was reappointed to the Cabinet under the new title of secretary for health and social care in Theresa May’s reshuffle on Monday afternoon.

It is the third time Mr Hunt has survived a cabinet shake up since becoming health secretary in 2012, as well as coming through two general elections unscathed.

An inspector won’t call

The Care Quality Commission has taken the unprecedented step of suspending routine inspections of hospital trusts during January because of the pressure on trusts this winter.

The move drew criticism from some staff who pointed out that the regulator was there to monitor and ensure minimum standards of care are not breached.

Chief executive Sir David Behan said: “Inspections scheduled in response to concerns about quality or safety will go ahead as planned. These include those that are in response to new information, as well as those to follow up on previously identified concerns… We will continue to monitor performance very closely and will act to protect people if necessary.”

NHS wish list

The next few weeks should see the setting of new marching orders for the NHS in the form of revised planning guidance from NHS England and NHS Improvement, and a refreshed NHS mandate from the newly renamed Department of Health and Social Care.

The ask of the NHS is always a matter of substantial debate behind the scenes, even when money is flowing, but is particularly in the spotlight this year: NHS England has said the service can’t meet all the current basic targets and improvement asks within the current resource envelope. It even raised the spectre of the government having to legally remove the NHS constitutional expectation of elective waiting times within 18 weeks – suggesting that, otherwise, there may be legal challenges.

The outlook of patients and the public on this – or at least, what they have told Healthwatch England – is not straightforward.

Healthwatch is, beyond NHS England, the only body the DH is required to ask about the mandate. In its official submission – shared with HSJ – it has indicated that retaining the flagship targets in their current form is not the be all and end all. 

And the winners are…

Four multimillion pound contracts have been awarded to winning bidders who will become major purchasing organisations for the NHS.

The contracts, awarded by the Department of Health, complete the procurement for 11 new “category tower” providers, who will buy common goods, medical equipment, consumables and other services on behalf of the NHS when the NHS Supply Chain contract expires in October.

These organisations will be tasked with delivering annual procurement savings of up to £600m by 2021-22, as part of the efficiency reforms that followed the Carter review in 2016.

The NHS spends £5.7bn a year on these categories of goods and services.

Two names that stood out among the four winners were DHL Supply Chain and North of England Commercial Procurement Collaborative.

DHL, which currently operates NHS Supply Chain, has now won three of the 11 contracts (the maximum number allowed) and is also involved in a fourth through a joint venture with US analytics firm Vizient.

North of England CPC is also involved in three category towers as it is one of four regional procurement hubs that make up the NHS Collaborative Procurement Partnership, which was awarded contracts by the DH last November.

Takeover tussle

Two trusts are going head to head in the battle for ownership over Shropshire Community Healthcare Trust.

With an income too small to be sustainable on its own, the trust is seeking a partner to help shore up its services and two providers have been shortlisted.

In one corner is Shrewsbury and Telford Hospital Trust, in the other South Staffordshire and Shropshire Partnership Trust.

Each with a different skill set, one an acute and one a mental health and community provider, both trusts believe that they are in the best position to take over their neighbour.

The winning provider is due to be chosen by NHS Improvement in March.