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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NHS prepares for potential attacks

Emergency departments across the NHS have been told to be ready to respond to a possible terrorist attack, following the raising of the threat level.

The terrorist threat level was raised from severe to critical – the highest level – after Monday night’s bombing at Manchester Arena, which killed 22 people. Police investigating the attack have said a terror network could have been behind the bombing.

An alert was sent by NHS England on Thursday to the 27 major trauma centres in the country urging departments to prepare and to ensure staff know what to do if an attack happens. HSJ understands it is the first time since the 2008 attack in Mumbai that NHS trusts have been sent this type of alert.

The message said: “There are a number of things that all trauma units and major trauma centres can do to prepare for a further incident and I should be grateful if you could disseminate these within your network so that frontline clinicians are aware.”

It urged trusts to ensure all staff have easy access to their major incident plan.

On Thursday morning, NHS England chief executive Simon Stevens told its board meeting that trusts are being urged to check staffing levels and mutual assistance plans.

Mr Stevens also said: “We owe a huge debt of gratitude once again to the frontline staff of the NHS who responded so brilliantly under these terrible circumstances.

“The emergency coordination response kicked in on Monday night and has worked practically flawlessly.”

HSJ also paid tribute to the staff and organisations who responded to the attack, at the HSJ Value Awards on Wednesday.

May backtracks on social care plan

The prime minister has promised a future Conservative government would introduce a cap on care costs, following widespread criticism at the weekend of her proposals for the funding of social care announced in last week’s manifesto.

Theresa May said the cap will be included in the forthcoming green paper on the future of social care expected in the autumn. However, she declined to say how much it would be worth.

Under plans unveiled in the manifesto, people will be asked to pay for their own care until they have £100,000 left in assets, including property. The costs will be recouped following a person’s death.

The policy was quickly dubbed a “dementia tax” by critics due to the likelihood that those who have the condition stand to lose the most in value of their assets due to the high costs and long term nature of care required.

Uncovering the numbers

When a much anticipated NHS report fails to emerge into the public domain, HSJ will do its utmost to step into the breach.

Last week the BBC reported how regulators have been prevented from publishing the year end financial performance report for NHS trusts – but our research has revealed the numbers.

HSJ’s research suggests the sector’s combined deficit for 2016-17 could be as high as £770m and around 100 out of 235 providers ended the year in the red, with dozens more only avoiding a deficit through one off savings or technical accounting measures.

The final reported figure is 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.

Mistakes in maternity care

Safety fears around maternity services have made a lot of headlines in recent months and after a number of worrying coroner’s reports, an HSJ investigation aimed to understand at least one possible factor in why babies are dying in NHS care.

Our enquiries have established that there are widespread mistakes in the interpretation of foetal heart rates, which can be a warning sign to babies being in distress during birth.

We obtained new data from NHS Resolution showing failures to act on abnormal foetal heart rates has been the primary cause of clinical negligence claims in recent years, with hundreds of cases costing the NHS almost £500m.

As part of the investigation, we looked at the training for students and staff, and coroners have warned they don’t think NHS trusts are doing enough to ensure midwives can properly understand heart rate readings.

More worryingly, HSJ found multiple reports in which the issue was highlighted as a major cause of negligence and death.

Beds occupancy at all time high

Acute bed occupancy hit a record high in the final quarter of 2016-17, while a long term reduction in the number of acute beds may be slowing.

NHS England bed occupancy data for January to March 2017 reveals 91.4 per cent of overnight hospital general and acute beds were full during the period compared to 91 per cent in the same period the previous financial year. When records began in 2000-01 overnight acute bed occupancy averaged 84.7 per cent.

Some 150 of the 179 trusts with acute beds recorded acute bed occupancy of 85 per cent or more – the target which clinicians and health experts use as the benchmark over which patient safety is put at risk.