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.
NHS and private hospital in legal wrangle
Spire Healthcare, the independently owned acute provider, is taking Heart of England Foundation Trust to the High Court over the breast surgeon Ian Paterson.
Mr Paterson was employed by HEFT but did private work at Spire. In the case, scheduled for October, the company will say that the trust’s failure to warn it of concerns about Mr Paterson’s conduct means it breached its duty of care to private patients.
The trust has said if the case is successful it would make the NHS liable to pay compensation to private patients – even where they have had no contact with taxpayer funded services other than being treated by doctors who do most of their work in the public sector.
Earlier this month, Mr Paterson had his jail sentence for performing unnecessary operations on hundreds of patients extended to 20 years.
NHS leaders today warned that the health service was near breaking point following publication of official figures showing stuttering progress against key performance targets during spring and early summer.
None of the NHS Confederation (the system is “unsustainable”), NHS Providers (the system was at “full stretch”), or the Royal College of Surgeons (figures must be a “wake up call”) could be accused of pulling their punches as they raised concerns.
The problem is, of course, that politicians have heard these warnings over the summer for years. And then every winter the system scrapes through.
But the figures are particularly chilling this time:
- The NHS waiting list likely breached the 4 million mark for the first time in a decade in June, following NHS England’s decision to relax the 92 per cent referral to treatment target.
- Trusts failed to make significant inroads on delayed discharges of care, with total days delayed rising from 177,137 in April to 178,441 in June. The figures are also higher than for the same period in 2016-17.
- Four hour performance showed signs of improvement – 90.3 per cent in July, down from 90.7 per cent in June, but is still way off the 95 per cent target.
Ministers cannot say they haven’t been warned. Again.
Keith McNeil announces departure
The NHS’s first national clinical chief information officer Keith McNeil is leaving after just 13 months in the role.
Dr McNeil will leave the NHS in December to return to Australia. He will take up a role as assistant deputy director general at Queensland Health and chief medical information officer for Queensland.
He said: “Although I am returning to Australia for personal and family reasons, I plan to keep a close eye on progress and look forward to seeing the digital transformation programme deliver benefits to patients and clinicians over the years to come.”
CCG leadership criticised
It’s not been an easy 2017 for Somerset Clinical Commissioning Group.
Increasing patient demand and a 40 per cent rise in costs of nursing home fees meant the CCG ended 2016-17 with its first deficit (of £3m) and its financial gap for 2017-18 stands at around £15m.
The financial challenge facing the CCG is felt across the Somerset Sustainability and Transformation Partnership, as the area – which includes a primary and acute care systems vanguard in Yeovil – is one of those in the capped expenditure process.
Once it became clear to the CCG that it wouldn’t meet its financial targets for 2016-17, it decided to commission a review into its own leadership.
The review, based on interviews with members of the CCG and external stakeholders, has not been published but HSJ obtained the executive summary.
It revealed, among other things, that the senior leadership has been spending too much time in meetings and its decision making ability is seen as “weak”.
Somerset CCG has accepted the review’s eight recommendations and is working to address the highlighted issues.
The departure of experienced leader David Slack at the end of August means new blood will be required to drive the organisation forward.
The shape of ACOs
Accountable care organisations can’t be simply “willed” into existence through a transactional process, NHS England says, but a national contract sure does help them along.
Last week, NHS England published its model contract for ACOs. Despite prior plans to have a separate contract for the development of multispecialty community providers, this new contract has superseded them and will be used for those looking to develop both hospital and primary care led models of care.
The new contract largely reflects the draft MCP contract, published in December.
Dudley leads the way
Dudley CCG has chosen to take forward a bid for its £5bn MCP contract from a consortium formed of GPs in the area with four NHS trusts.
It is expected to become the first, or one of the first, instances of a contract for a comprehensive MCP.
The trusts are: Birmingham Community Healthcare Trust; The Dudley Group FT; Dudley and Walsall Mental Health Partnership Trust; and The Black Country Partnership FT.
According to the commissioner, the GP collaborative which has signed up to the consortium covers 41 GP practices, over a population of 289,272.
Dudley CCG has said it will enter the competitive dialogue process for the 15 year contact in early September and hopes to have the contract in place by spring 2018 – which would make it the first MCP to go live.