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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Clarity amid the tumult

Delegates attending the NHS Confederation conference this week had every reason to expect they would be met by a new health secretary, that having been the pre-election gossip. The NHS had even gone so far as to find its own candidate, propelling the rumour mill that former Cabinet Office boy Ben Gummer would replace Jeremy Hunt. Not only did a major reshuffle not materialise in the context of the Tory non-majority, but Mr Gummer lost his seat altogether.

So the Department of Health’s own remarkable uptick in health secretary longevity and retention was centre stage at Confed 2017, as Mr Hunt appeared for his fifth conference in the post.

Unfortunately the same trend in workforce security is not the case for the NHS itself. And Mr Hunt could hardly help but identify staffing as the major focus for the NHS – including retention, which he said had fallen recently, posing “searching questions” about why that was.

Mr Hunt offered a glimmer of light on dropping pay restraint (amid the Tories’ soul searching on austerity); and both he and later on Simon Stevens pressed the message that we do need staff from overseas, as well as “homegrown”.

There were searching questions too at Confed about what the current government in limbo means for the health service.

Mr Hunt said health legislation was very unlikely in the short term but – in a show of optimism about his further job security – that there could be something “after Brexit” if cross party support is agreed with Labour.

Simon Stevens – who normally delivers a masterclass of policy wizardry sprinkled with charts – this time sprinkled his speech with real human stories; and sought to offer clarity about what to focus on amid the tumult.

That means sticking to Next Steps of the Five Year Forward View – dust it off and read it if you have not already, was the NHS England boss’ order – and NHS England announcing the first “accountable care systems”, seeking to give some welly to the integration and health system agenda.

Pats on the back were issued as it was confirmed the NHS had overall balanced its books in 2016-17 – a big improvement on last year but, as Jim Mackey said on Wednesday, unfortunately you’ve got to do it all again this year.

Mackey’s mission impossible

NHS trusts are predicting a deficit close to £500m this financial year, NHS Improvement chief executive Jim Mackey revealed at Confed 2017.

National regulators previously said the trust sector would need to break even in 2017-18, but the NHSI boss said trusts’ financial plans aggregated to a deficit of £496m.

This is similar to the figure envisaged by NHS Providers earlier in the year.

Mr Mackey also revealed the provider sector ended last financial year with the deficit of £791m, which was within the £800m “risk reserve” held back from commissioning budgets.

HSJ’s research last month had suggested the provider sector’s combined deficit would be £770m. We said the final reported figure was likely to be lower – between £750m and £700m – due to further one off adjustments that may not have been finalised before trusts reported their numbers to regulators.

Mr Mackey said the NHS “overall” had achieved “the impossible” in delivering a breakeven position in 2016-17 but the bad news was “we have to do it again”.

Big deal for NHS land sales

The government is poised to agree several major deals with private firms to unlock capital funds worth £5.7bn by selling NHS land and property.

Several sources confirmed to HSJ that in response to the Naylor report on the NHS estate, six regional public/private partnerships will be created under the plan to dispose of assets that are no longer required or not fit for purpose.

The plan is named Project Phoenix. Under the PPP deals it is likely the profit from sales would be shared between the NHS and the private partners – though how the cash would be split has yet to be revealed.

The project is part of the response to the report on NHS estates by Sir Robert Naylor, who said the service should adopt “a far more commercial approach” to managing its assets in order to release much needed funds.

HSIB gets to work

When news came that Jeremy Hunt was setting up a new healthcare safety organisation, there were many who feared it would be another regulator aiming its fire at under pressure staff and trusts trying to do their best in difficult circumstances.

But Keith Conradi, chief investigator of the new Healthcare Safety Investigation Branch, has moved quickly to quell any fears and make clear it’s the NHS system regulators who should be keeping an eye out for HSIB’s work. In an exclusive interview with HSJ, Mr Conradi says he will look to challenge regulators like NHS England and NHS Improvement rather than individual trusts.

This approach is likely to be welcomed across the board as it is often said that the systemic issues within the NHS are rarely if ever tackled but failure to do so dooms the service to repeat mistakes.

HSIB is not starting slowly either – Mr Conradi confirmed details of its first full investigation, which was triggered after a patient died while being transferred between services. HSIB is now examining the incident, as well as others, to look at whether there is a systemic problem around transfers between hospitals of deteriorating patients.