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.
Ted Baker well suited to be chief inspector
Professor Sir Mike Richards is retiring as chief inspector of hospitals next month, and his successor will be Ted Baker, his current deputy at the Care Quality Commission.
Professor Baker has been Sir Mike’s deputy since January 2014, and has previously worked as medical director and deputy chief executive at leading hospital trusts.
The appointment brings continuity of clinical leadership at the CQC.
There have also been significant changes at NHS England with a restructuring of its national senior management teams.
The restructure aims to reflect and support a shift in NHS England from planning and strategy to operational delivery of the Five Year Forward View.
Notable silences in the Queen’s speech
Ripping up and replacing the Mental Health Act was a big commitment for Theresa May.
New legislation for independence and legal powers for HSIB was a big commitment of Jeremy Hunt.
Then the election happened and such commitments have been lost in the chaos.
In the Queen’s speech on Wednesday – setting out the government’s legislative programme for a two year parliamentary session – several Tory manifesto pledges went unmentioned, and there was no firm plan for any new health and social care legislation.
Keith Conradi, the chief investigator for HSIB, has said he believes that without statutory powers the NHS could ignore HSIB’s recommendations and “no difference will be made”. The Conservative manifesto had committed the government to legislation.
Manchester commissions Manchester
A single bid was received for the 10 year contract worth £5.9bn let earlier this year to provide integrated out of hospital services across the city of Manchester. And, we revealed on Friday, the winner is… (drum roll…) all the existing NHS and public sector providers.
Manchester Health and Care Commissioning has received a single bid from the Manchester Provider Board, which is a consortium made up of Manchester City Council, local GP federations, the city’s three acute trusts, community service providers and Greater Manchester Mental Health Trust.
Worries at Worcestershire
A trust where patients died in the corridors last winter has been rated inadequate again, with the Care Quality Commission suggesting outside support will be required “for the foreseeable future”.
The CQC’s inspection report has revealed a long list of failings at Worcestershire Acute Hospitals Trust, where performance, particularly in emergency care, has continued to worsen since it was placed in special measures in December 2015.
Last winter was particularly difficult for Worcestershire Acute’s accident and emergency services, which reported three patient trolley deaths. The trust was singled out by health secretary Jeremy Hunt in January as the trust the Department of Health was “most worried about”.
HSJ revealed earlier this month that a preliminary CQC report had identified widespread problems at the trust including a “culture” of patients being kept in corridors, medication errors and poor infection control.
In its final report, the CQC recommended the trust remain in special measures for at least another three to six months to allow the new executive team to push through “urgent improvements”.
Trust chief executive Michelle McKay, who joined the trust in March as one of four new senior appointments at the trust since September, said more stable leadership should help drive improvements.
The community hospital dilemma
HSJ has published the first ever analysis of safe staffing figures for community hospital wards.
The data does not bode well for these services with nearly a third of trusts with a community hospital ward failing to meet their own nurse targets for the past two years.
Our analysis shows these trusts consistently failed to hit the level of planned nurses during the day on their wards and data suggests the situation is getting worse.
But beyond the data the story is not so clear cut. Many of the trust’s that responded to HSJ said they have ambitious plans, which is why they appear to be failing in comparison to other trusts who set the bar much lower.
Health Education England’s chief executive Ian Cumming has said he wants to ensure the UK is self-sufficient for nurses and is aiming for a small surplus across all healthcare professions.
In an interview with HSJ, Professor Cumming said a key focus for the education and training body would be improving the retention of staff in partnership with the wider NHS.
Dirty work at the crossroads
The regime governing how additional funding is allocated to NHS trusts has been described as “economic lunacy and grossly unfair” by a widely respected former regulator and trust chair.
Sir Peter Dixon – former chair of University College Hospitals London Foundation Trust, several turnaround trusts, and other things – also warned that rules around the extra funding have encouraged “dishonesty” and “bullying”, which he said is now “as bad as I’ve ever known”.
He said: “If trusts are hitting their control totals because they’ve done prudent things and made genuine efficiencies then that’s justified, but if you’re suddenly pulling a rabbit out a hat in quarter four when your board reports throughout the year have suggested a big overspend, then it’s usually dirty work at the crossroads.”
Those with a memory will recall Sir Peter has a record of sticking it to the man, having in 2009 – while he was at UCLH – caused something of a stir by declaring there was a “Stalinist culture among SHAs”.