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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The case for capital

NHS Improvement has highlighted the hopefully-obvious-to-ministers importance of capital investment to fire safety.

An investigation by HSJ, which started earlier this year, reveals a range of concerns related to outstanding enforcement notices; maintenance backlogs; problems with private finance initiative buildings; and issues related to compartmentalisation – which is meant to restrict fires spreading.

In the wake of the Grenfell Tower disaster the use of external cladding has also come to the fore as a potential fire risk – we’ve already reported on how trusts have been asked to review their use of such materials.

However, NHS Improvement’s response to our investigation makes it clear that there is much more than cladding to worry about. Emphasising that fire safety should be an “absolute priority” for the NHS, the regulator said it was working with providers to identify risks and ensure the right action is being taken, “both in terms of cladding specifically, but also on fire risks more broadly”.

As ever – money matters. The statement continued: “The NHS is a huge and varied group of buildings and facilities, so there is some complexity in this.

“To address some of the variations involved and make sure all of that estate is as safe as it can be, we are looking at how we can generate more capital investment in the NHS – backed by a commitment from the government to spend more on NHS capital.”

If the Conservative Party’s election manifesto still matters, there was a pledge for a major capital investment programme – NHSI clearly hasn’t forgotten that Theresa May has backed the Naylor report and pledged £10bn of capital investment off the back of its recommendations.

Going soft on controlling NHS spending

After plenty of tough talking behind the scenes, this year’s big drive to control NHS spending appears to have been softened up by regulators.

The “capped expenditure process”, which introduced a shared financial target for providers and commissioners within 14 struggling health economies, had ordered local leaders to start making “difficult choices” to control spending.

But when some of the potential implications – including lengthening waiting lists, reduced staffing levels and service closures – started to filter through to the mainstream news pages last week, it seems ministers got cold feet.

National leaders have now accepted that only around half of a near-£500m financial gap can feasibly be closed, and even that will come with a lot of risk.

Dido in line to be NHS Improvement chair

A Conservative peer and former chief executive of the broadband giant TalkTalk is a leading candidate to be appointed as chair of NHS Improvement, HSJ has learned.

Dido Harding left TalkTalk in May, having said she wanted to concentrate on “more activities in public service”.

HSJ understands Baroness Harding is on the candidates list for the role and seen as a strong contender. A final decision has not yet been made by health minister Philip Dunne, who is expected to meet several shortlisted candidates.

If put forward as the preferred candidate by the Department of Health, Baroness Harding would appear before the Commons health select committee for a pre-appointment hearing.

Ed Smith, current NHS Improvement chair, is expected to step down shortly. The organisation’s chief executive Jim Mackey is due to return to his substantive role as a foundation trust chief executive in the autumn.

The problem of unwarranted variation

Professor Tim Briggs, chair of the Getting It Right First Time initiative, says the NHS will only survive if it addresses the “enormous” problem of unwarranted variation.

His comments were published this week in a report by the King’s Fund, shared exclusively with HSJ.

The report quotes Professor Briggs saying: “Money for social care aside, where there is a massive problem, there is no way right now I would ask for more money for the NHS.

“The waste and variation out there is unbelievable and we have got to get our act together across all the specialties to improve quality and unwarranted variation and complications.”

The prof has also said the NHS must stop “leaking” £1.4bn to private providers to ensure its survival.

Southern Health pleads guilty

Southern Health Foundation Trust has pleaded guilty to causing a patient life altering injuries through safety failures. 

It pleaded guilty to failing to provide safe care and treatment to its patients at Basingstoke Magistrates’ Court. It is the first time the Care Quality Commission has used its regulatory powers to bring a prosecution against a trust.

The CQC announced in March that it was prosecuting the trust after a patient under Southern Health’s care broke his neck when he fell from the roof of one of its hospitals, Melbury Lodge, Royal Hampshire County Hospital in Winchester.

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.

The CMA investigation will consider whether the merger “may be expected to result in a substantial lessening of competition within any market” and if this would be outweighed by any patients benefits.

Mann names his price

The NHS’s clinical lead for accident and emergency says the chances of hitting the 95 per cent four hour target by next year is contingent on addressing delayed transfers from hospitals.

You knew that already, of course. But what Cliff Mann has now told us is he estimates that the NHS needs to persuade councils to spend £100m of £1bn worth of new social care cash allocated for this financial year on reducing delayed discharges.

Dr Mann describes it as a “relatively small proportion” – but even getting this will prove challenging, judging by the mood music coming from councils, which are looking to use it to plug existing holes after years of funding cuts

Mental health: a priority

Once upon a time mental health was a Cinderella service.

But these days it feels impossible to continue to call it such, with the increased media attention and high profile proponents transforming it into a national priority.

In a wide ranging interview with HSJ, national medical director Claire Murdoch said it is “mental health’s moment now”.

She said there was “power in the system” and the sector has the backing of Simon Stevens, Theresa May and Jeremy Hunt.

The big issues are still money and workforce.