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.

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Hunt’s delayed discharges drive met with cool response

New government measures to speed up delayed discharges, including cutting funding for councils failing to hit new targets, have been met with scepticism from NHS leaders and their local government counterparts.

It was encouraging that ministers were attempting to address the issue, NHS Providers said, but Chris Hopson said its warning still stood that unless around £350m was put into providers now, the system will fall over this winter.

The Association of Directors of Adult Social Services was even less impressed. President Margaret Willcox said ADASS was “very disappointed by the last minute unilateral changes to guidance that have taken place in the last few days”.

Ms Wilcox did not elaborate on which changes had irked ADASS, but did say “the consequence is to undermine the collective effort required”.

The sense that relationships are already strained does not bode well for the prospects of addressing a problem that can only be solved through significant amounts of collaboration across the great NHS/social care divide.

Three trusts fail cladding tests

Three trusts have failed fire safety tests ordered in the wake of the Grenfell Tower disaster.

NHS Improvement said three trusts have seen part of their cladding fail combustibility tests: King’s College Hospital Foundation Trust and North Middlesex University Hospital Trust in London; and Sheffield Children’s FT.

King’s and Sheffield have already removed the cladding.

Pay rise not enough to boost staff morale

Ever since the election, more and more people have been calling for an end to the 1 per cent cap on public sector pay rises – often with an emphasis on frontline NHS staff.

Last month, Jeremy Hunt hinted that he could lobby for an end to the policy, while NHS grandees such as Stephen Dorrell and Sir Mike Richards have also called for staff to be “fairly” and “properly” rewarded.

The prime minister has apparently declared the age of austerity over and cabinet members have suggested the government could consider ending pay restraint in the autumn budget – though the Conservatives voted against a Labour amendment challenging the cap last week.

But what does the man overseeing the provider sector’s finances think?

NHS Improvement chief Jim Mackey was typically to the point on Wednesday: “If and when the pay cap is lifted, there needs to be money to back it.”

When pressed by HSJ if that meant “new money” for the NHS, Mr Mackey said: “I’m not making the decision but in my view… I’m not sure how we would generate that level of internal efficiency to get that.”

Speaking at the Patient Safety Congress in Manchester, he was the first national NHS chief to comment on the issue since calls for a pay rise increased after 8 June. (Though when announcing a bunch of new measures to improve staff retention last month, NHSI nursing director Ruth May also told us: “Pay is part of the equation. We can’t ignore it. Having seven years of a freeze on pay is having an impact on retention.”)

Mr Mackey was clear that ending pay restraint alone would not be enough to improve staff morale – echoing the views of Sir Robert Francis, who was speaking at the congress a day earlier.

The Mid Staffs inquiry chair even said a pay rise may be a “mirage” in the drive towards improving NHS staff morale – because “if the economy collapses it might not be worth more”.

“We need to do whatever it takes to recruit more people and make the job more attractive for them. That may involve more pay but also involves better conditions such as not working extra hours without being paid for them,” he added.

Both bouquets and brickbats for STFs

There’s been plenty of criticism around the mechanics of the £1.8bn sustainability and transformation fund in 2016-17, but for some trusts it’s worked out very nicely.

And it’s not just the big teaching trusts like Central Manchester University Hospitals Foundation Trust and University College London Hospitals FT that have benefitted.

Many organisations in the long neglected mental health and community sectors have also received large chunks of “bonus” money from the STF (along with ambulance and specialist trusts) – which is effectively cash that was initially earmarked for the acute sector.

This is a very roundabout way of getting more money into non-acute organisations (and this may not even have been the intention), although the recipient trusts will be feeling pretty cheerful at the end result.

The previous criticism still stands however, as trusts which benefitted the most were able to do so because of one off transactions such as land disposals or some clever accounting. And of course, all the trusts which failed to meet their target – whatever the sector – will have simply fallen deeper into debt.

Midlands merger investigation

Competition regulators have launched a formal inquiry into a long mooted merger which would form one of the largest acute trusts in the country.

The Competition and Markets Authority investigation will consider the merger between University Hospitals Birmingham Foundation Trust and Heart of England FT. If approved, the combined trust would have a turnover of over £1.4bn.

UHB and HEFT already share chief executive Dame Julie Moore and chair Jacqui Smith. Dame Julie is also the STP lead for Birmingham and Solihull.