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.
Sir Mike’s ‘unfinished business’
More trusts may face prosecution under the Care Quality Commission’s powers, Professor Sir Mike Richards confirmed in his exit interview with HSJ.
Sir Mike, who retires from his role as chief inspector of hospitals this week, said the recent successful prosecution of Southern Health should act as a “deterrent” for other trusts and the regulator was already considering starting legal proceeding against an unspecified number of trusts.
He also used the interview to signal that the NHS must try harder with cancer waiting times. He said hitting the 62 day treatment target “ought” to be possible. The NHS has failed to meet the target for over three years. Revealing that he was taking up a trustee position at Cancer Research UK, he admitted that driving up cancer outcomes remained “unfinished business” for him.
More changes at NHS England
An NHS England regional director has announced her departure this autumn.
Anne Rainsberry, London director for the national commissioning body, resigned in April but she “agreed with the NHS England leadership team that she would announce it in the summer so as not to be a distraction during the important planning and budgetary process for the next two years”, a spokesman said.
An NHS England spokesman said Dr Rainsberry would be “leaving the NHS” after a career of 33 years in the service.
When surpluses suddenly turn into a blackhole at a hospital trust, it is right that there’s a proper investigation into what went wrong.
It appears Deloitte carried out a proper investigation at Gloucestershire Hospitals Foundation Trust, but you can’t know for sure because the trust has only released an abridged version of its report.
The extract contains two pages covering what went wrong. It’s not clear what the wider NHS can learn from this summary.
The auditors place a lot of the blame with a now departed chair, chief executive, finance director and chair of the finance and performance committee.
Local commissioners must deliver efficiency savings of almost 4 per cent to meet their financial targets this year, despite failing to get close to last year’s target of 3.2 per cent.
HSJ also understands around 20 CCGs have been asked to resubmit their plans with a “more challenging” savings target. If they do so, this would push the average savings requirement higher.
The financial plans for CCGs, which are based on their funding allocations and have now been assured by NHS England, demand average efficiency savings of 3.8 per cent in 2017-18, according to NHS England’s finance report for July.
In 2016-17, CCGs had to plan for savings of 3.2 per cent but only achieved 2.6 per cent.
Meanwhile, the new chair of the Academy of Medical Royal Colleges, Professor Carrie MacEwen has called for an “honest conversation” about what the NHS can afford to provide.
Hewitt returns full of eastern promise
Patricia Hewitt’s tenure as health secretary between 2005 and 2007 coincided with a period of austerity for the NHS and should serve her well in her new role as independent chair of Norfolk and Waveney STP.
However, it is her experience following her parliamentary career that Ms Hewitt has pledged to draw on as she seeks to help the STP create plans to address its forecast £415.6m deficit by 2021.
She has spent the last eight years chairing the UK India Business Council, working extensively with Indian healthcare providers, who she said had developed some “extraordinary innovations”.
In serious need of improvement
Last Friday was ratings bonanza day at NHS England – judgements were published under the clinical commissioning group assessment framework, and – for the first time – on the sustainability and transformation partnership “scorecard”.
STPs are spared the punitive terminology that the rest of the NHS gets labelled “needs most improvement” instead of “inadequate” and “making progress” instead of “requires improvement”. That’s perhaps only fair since STPs don’t actually, really exist, making their job rather difficult. But it is notable that at the top of the class they are entitled to be labelled “outstanding”. “Somehow holding it together” seems more appropriate.
While NHS England has had informal private ratings of where STPs have got to probably for a year, the experience of STP leaders suggests that the details of these first public judgements have been cobbled together rather late in the day – many were not aware that their leadership was being scrutinised for this purpose. On the more positive side: It is great news to have a meaningful whole system judgement, and a dashboard focused largely on integration and prevention of reliance on emergency hospital care. Here is our detailed view of the new information.
Matthew Swindells, who is in charge of this, stresses that they are only a baseline and largely can’t be attributed to the failings or successes of STPs, being as it’s early days: the future is only just arriving so don’t give it a kicking yet.
Because CCGs have endured four years of being battered, bruised and abused already, they have earned the full force of punitive terminology: 23 were rated “inadequate” down from 26 for 2015-16; and 66 “requires improvement”, down from 91. The number rated “outstanding” more than doubled from 10 to 21.