Your essential update on the week in health

HSJ Catch Up

This new 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.

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Mackey faces backlash over clinical staff warning

Chief regulator Jim Mackey stepped into controversial territory this week by talking about cuts to clinical staff numbers, and suggesting the ratio of one nurse to eight patients is unaffordable.

In comments that have been jumped on by readers and clinicians, Mr Mackey said trusts exceeding the ratio could be told “we can’t afford that”.

The regulatory message appears to have hardened since August 2015, when trusts were told to “ensure vacancies are filled only where essential”. This rather vague communication was quickly clarified by Monitor (now rolled into NHSI), which said it was “not telling trusts to stop recruiting clinical staff”.

But trust finances have worsened significantly since then, and Mr Mackey said cuts to clinical staff numbers were “possible” at some trusts, such as those which have gone “beyond the safe staffing requirement”.

This drew speedy criticism on Twitter, including from safe staffing expert Jane Ball, who said: “Mackey seems unaware of NICE guidance: Trusts should consider 1:8 a warning level of possible insufficiency. NOT a goal/max.”

Mr Mackey also described royal college standards on staffing as “aspirational”, which drew stinging criticism from professional bodies, including the Royal College of Paediatrics and Child Health, which described the comments as “extraordinary” and “shabby”. The strong words kept coming, when Mr Mackey told a conference the NHS “is in a mess”.

Jeremy Hunt stays as health secretary

Jeremy Hunt remains health secretary – one of only two cabinet ministers staying in the same post following Thursday’s massive clearout by the new prime minister, Theresa May.

It was variously reported by well regarded media outlets – and HSJ was culpable in this, for which we apologise – that Mr Hunt had been sacked from the cabinet altogether, moved posts, voluntarily stepped down, and had his department expanded.

At 12.44pm it was at last, 100 per cent confirmed that Mr Hunt had just remained in exactly the same post.

There were plenty of people celebrating his departure, of course – indicating the major morale and relationship challenge Mr Hunt still has on his hands.

However, quite a few took the moment to praise his focus on patient safety. Junior doctor Natalie Silvey tweeted: “May be unfashionable to say it but I do believe Jeremy Hunt genuinely cares and did have patient safety at the core of his time as minister.”

NAO finds ‘astonishing array or errors’ in UnitingCare Partnership collapse

On Thursday the National Audit Office delivered the latest withering official post-mortem of the £750m UnitingCare Partnership contract fiasco.

The report boldly underlined the “astonishing array or errors” that resulted in the collapse of the older people’s services contract, many of which were first flagged up by previous investigations into the disastrous deal.

The document also revealed that the Department of Health, NHS England and NHS Improvement are “developing their approach” to regulating new models of care such as lead provider contracts.

‘Technical’ measures cut £900m from provider deficit

A series of one-off accounting measures helped boost the reported performance of the NHS provider sector by around £900m last year, according to figures obtained by HSJ.

NHS Improvement released details of the measures following a freedom of information request by us.

The actions, coupled with the deferral of capital spending, boosted the provider deficit by around £1.2bn. Assuming they were all one-off measures, this would suggest an underlying deficit of around £3.7bn. But some of the measures may have delivered recurrent savings.

Brexit worries continue

Specialist trusts and those in London have the largest proportions of staff from the EU, HSJ analysis revealed on Monday.

The chief executive of Great Ormond Street – which has one of the largest proportions of EU staff – and others have expressed their concerns about the impact of Brexit.

The trusts most reliant on EU workforce may be more at risk from the prospect of fewer staff coming to the NHS from the continent, or those who are here leaving in the wake of the referendum.

HSJ has launched a special award to celebrate the contribution of the NHS’s staff from the EU.

CQC chief inspector responds to query on care quality data

Last month Dave West wrote about how the NHS now has an unprecedented amount of information about care quality in hospitals, but regulators had not indicated what they were going to do with it.

In an article for HSJ on Monday, the CQC’s chief inspector of hospitals provided his answer. Sir Mike Richards said: “The short answer is that it should use it to drive improvement: to build on good quality where it has been identified and learn from the examples of good and outstanding care to do better.”

Naylor’s successor named

University College London Hospitals have finally managed to find a successor to Sir Robert Naylor – who was supposed to leave in March but stayed on after the high profile teaching trust was unable to find a suitable replacement.

Now we know who will be stepping into some of the NHS’s biggest shoes: Professor Marcel Levi, who will be joining from the Academic Medical Centre in the Netherlands, where he has been chair of the executive board for 16 years, as well as being dean of the faculty of medicine at Amsterdam University.