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.
Labour manifesto leaked
A new NHS regulator was the notable health policy in a leaked draft of Labour’s manifesto, which was given to a few newspapers this week. The final document is expected to be unveiled next week.
The draft, one of several versions, provides more detail of how a Labour government would “halt” the 44 sustainability and transformation plans and redraw them “with a focus on patient need rather than available finances”.
This would be overseen by a new regulator called NHS Excellence. It is unclear whether the second NHSE would replace the likes of the CQC and NHS Improvement.
It says £6bn of extra funding would be raised for the NHS annually by increasing income tax for the top 5 per cent of earners. Money would also be saved by “halving the fees paid to management consultants”.
Rather than “dragging the country back to the 1970s”, Incisive Health’s Ben Nunn suggests that many ideas are similar to those from New Labour’s 1997 manifesto.
Stevens sets out post-election reality
No matter who wins the general election on 8 June, “there is no version of reality” where the NHS will change the priorities of the Next Steps for the Five Year Forward View.
The NHS England boss told a King’s Fund event: “Without prejudging the outcome [of the election] – we will obviously be guided by the new government – it is pretty clear that the core operational priorities that the NHS set out in Next Steps document are the right things for us to be working on over the year ahead.
“There is no version of reality where we don’t need stronger primary care; no version of reality where we don’t need more expansive and resilient mental health services; no version of reality where we don’t need better health and social care integration – to name just three.”
He added that 2017-18 “will be a sleeves rolled up year with a lot of change across the country”.
A&E admissions continue to rise
Performance data that MPs and potential MPs from all parties should look at was released on Thursday.
The number of hospital emergency admissions rose 2.8 per cent in 2016-17 to 4.3 million, with March this year seeing the largest ever number in a single month.
Nuffield Trust analysis shared with HSJ shows total accident and emergency admissions rose from 4.15 million to 4.26 million year on year, continuing a rising trend, despite efforts by national leaders and the NHS to stem the growth.
The scores on hospital doors
Something else we can expect after the election is a new scorecard for measuring accident and emergency performance.
NHS Improvement first announced intentions to make a fresh attempt at developing a new way to measure trusts’ performance, which factors in issues such as acuity and patient experience as well as waiting times, last December.
HSJ has been told the scorecard could be “launched as early as June”, but development is ongoing and many of the core elements have not been finalised.
Making large recurrent savings usually depends on two things that are extremely difficult in the NHS – cutting staff numbers and treating fewer patients in hospital.
The frequent failure of trust mergers and service reconfiguration to release the expected savings (in the words of the King’s Fund: the evidence is “almost entirely lacking”) usually comes back to these difficulties.
But this hasn’t deterred those planning the merger of Central Manchester University Hospitals Foundation Trust, University Hospital of South Manchester FT and North Manchester General Hospital, who reckon they can deliver total savings of £105m by 2021, with £42m saved recurrently from that point.
The trusts will of course be helped by a sizable pot of transformation funding, and there is lots of duplication of clinical services, which should mean plenty of scope for securing efficiencies.
Southern Health prosecuted
Southern Health Foundation Trust is being prosecuted by the Health and Safety Executive following the death of a patient.
Connor Sparrowhawk, aged 18, drowned in a bath following an epileptic fit while he was in the care of the trust. He died in July 2013 and the trust admitted responsibility for his death in 2016.
In the last five years the HSE has carried out four prosecutions against NHS trusts following patient deaths that resulted in successful convictions, according to its website.
Southern Health is also facing prosecution from the Care Quality Commission after another patient sustained serious injuries following a fall from a low roof at Melbury Lodge, Royal Hampshire Hospital.
GPs turn it around
Data, shared exclusively with HSJ, also shows that 52 practices inspected twice have since been “de-registered”, meaning they no longer provide GP services. Six of these followed enforcement action by the regulator.
According to the CQC’s figures, out of 151 practices initially rated inadequate, 40 have had their rating changed to requires improvement and 80 jumped to good, following a second inspection.