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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Chief executives must work on consolidation plan

Another month, another missive – NHS Improvement has sent a further message to trust chief executives, outlining which back-office services they should prioritise in consolidation plans. The email follows queries about which back-office services should be included in the plans.

The message follows letters sent in June and July instructing trusts to draw up plans to squeeze savings out of back office, pathology and “unsustainable” elective care services.

The consolidation process still has the potential to provoke controversy. A crucial factor about the “back-office” is that it underpins the working lives of everyone employed in the NHS. People don’t give it much thought when things are ticking along effectively, but it’s a very different story when someone messes up the payroll or if you can’t log into your email.

The next challenge for Hinchingbrooke

Hinchingbrooke Health Care Trust’s staff and management deserve huge credit for turning the trust’s performance around and getting out of special measures, but the story about this small but closely watched trust is far from finished.

It was telling that the one area where it still requires improvement, according to the CQC, is its accident and emergency department. As trust chair Alan Burns told HSJ on Thursday, the hospital is struggling to staff the department and demand is “going through the roof”.

The management is pinning its hopes of securing clinical and financial sustainability on merging with (in reality being acquired by) Peterborough and Stamford Hospitals Foundation Trust, which has a whopping deficit, largely related to a PFI deal.

The trust’s chair was quite clear to HSJ that his intention is to retain a full service emergency department and not follow the likes of Grantham, a significantly smaller hospital, which announced this week it was considering reducing its emergency department’s opening hours.

Recruiting non-executives for NHS boards

NHS Improvement is courting more than a dozen FTSE 100 companies, including Barclays and IBM, to find new non-executive directors to sit on NHS trust boards, HSJ reported on Wednesday.

In a letter to trust chairs, the regulator said firms could offer their “top talent” to the NHS as part of efforts to support top table leadership at trusts. NHS Improvement is also working on a strategy to support board development, and reiterated its desire to have a 50/50 gender balance on boards by 2020.

A number of HSJ readers suggested that recruiting non-execs from outside the NHS would be the main challenge: “We struggle to get non-execs from these backgrounds and it is hardly surprising! Why would they want to do something when the centre is micromanaging everything?”

In response, the letter’s author, NHSI director of corporate affairs Helen Buckingham, wrote in the comments section: “We’re not just working with the FTSE100… but also looking at other ways to improve the diversity of boards across a number of areas. All thoughts on how best to do this will be very welcome.”

Pennine Acute rated inadequate

As previewed by HSJ earlier in the week, on Friday Pennine Acute Hospitals Trust was rated inadequate by the Care Quality Commission, which raised concerns about staffing levels, infrastructure, systems, culture and leadership.

It has been widely known that serious concerns were raised during the inspection earlier this year, with Sir David Dalton of Salford Royal Foundation Trust taking over as interim chief executive as a result. The CQC confirmed his appointment meant the trust avoided being put into special measures.

The former chief executive, Dr Gillian Fairfield, apologised for not tackling the organisation’s problems more quickly.

Nursing shortage may go on beyond 2020

While the health service has scoured the globe looking for nurses to fill gaps, Health Education England has been confidently saying it has increased the number of nurses being trained and it believed it would close the demand supply gap for nurses by 2019-20.

There is a big “if” to this plan, revealed by HSJ on Monday, which is that it depends entirely on the plans for reducing hospital activity spelled out in the Five Year Forward View.

According to data from HEE, NHS acute trusts are continuing to forecast a demand for adult nurses that exceeds what HEE would expect if trusts shifted activity out of the acute sector as planned by the NHS England plan. Now the training body has been explicit – unless trusts get on board with the forward view, it will not be able to close the gap between supply and demand. This means the national shortage of nurses affecting every hospital in the NHS will continue into 2020 and beyond.

Providers may need to double efforts for control totals

In a new report on NHS finances, the Nuffield Trust said providers have only managed savings of 2 per cent in recent years, and would have to double this rate to achieve the “control totals” mandated by NHS England and NHS Improvement for 2016-17.

Savings of 2 per cent are widely deemed to be a realistic ongoing target for the sector, as outlined in Lord Carter’s report on NHS productivity, and by former Monitor chief executive David Bennett.

Inquests denied

Discrepancies in official data examined by HSJ suggest hundreds of patients who died while being detained under the Mental Health Act could have been denied inquests.

By law, all deaths in state detention should be reported to the CQC and examined by a coroner.

However, inconsistencies between official data on deaths reported to coroners in England and Wales and notifications sent to health regulators by NHS trusts suggest coroners may not have conducted inquests into every death.