Your essential update on the week in health

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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Stevens on the attack

Simon Stevens was under fire on Wednesday morning, with the front page of The Times reporting claims that Number 10 was unhappy with the NHS England chief for his lack of enthusiasm for the NHS recovery plan and responsiveness to mounting pressure.

Unfortunately for Downing Street he had the perfect platform to hit back with full force and style, drawing heavily on both his sharp intellect and top level political experience.

Mr Stevens appeared before the Commons public accounts committee. He stuck by his guns in asserting that the government had not met the NHS’s full request for funding. He also:

  • Indicated that a comparison of UK health spending with the OECD – by Department of Health permanent secretary Chris Wormald, who was sitting next to him – was misleading, and instead held up a story from the Daily Mail in November which said the UK spent less on its health service and had less doctors and other resources than other EU countries.
  • Joked that “I’ve been running a campaign against” cuts to social care by the government, continuing “enthusiastically I might add” – in what must be a reference to the Downing Street briefing in The Times that it was unhappy as he was too “unenthusiastic”.
  • Unprompted, raised his proposal for a social care funding settlement paid for by revising other publicly funded entitlements for older people – something which has also apparently irritated Theresa May and friends, because he is foraying into political territory.

> Leader: Simon Stevens will not resign – yet

2017 will be all bad… or will it?

Ok, bear with us. It feels like 2017 is going to be pretty bad. We’ve got plenty of reasons why it will be too. Winter pressures are as intensive as ever this week – there appears to be a horrendous situation in Worcestershire. Meanwhile, Jeremy Hunt is turning up the volume on moves announced before Christmas to effectively downgrade the four hour accident and emergency target, to allow a “greater focus” on sickest patients.

Mr Hunt said: “We are committed to delivering the four hour commitment. If we are going to protect our four hour standard we need to be clear it is a promise to sort out all the urgent health problems within four hours, not all health problems, however minor.

“NHS England and NHS Improvement will continue to explore ways to ensure at least some of the patients who don’t need to be in our A&Es can be given alternative options building on progress under way with the streaming policy in the NHS England A&E plan. This way we will be able to improve the A&E experience for those with more minor condition and protect the four hour promise for those who need it.”

But if you are in search of hope among the darkness – or even some good new basis for your pessimism – read our recent leader column.

May on the defensive

Theresa May was inevitably asked about the NHS during prime minister’s questions earlier in the day, with the opposition trying to put her on the back foot over increasing pressure in emergency departments.

The PM rejected the use of the term “humanitarian crisis”, used by the British Red Cross and repeated by Jeremy Corbyn, to describe the state of A&Es. But added: “I accept there have been a small number of incidents where unacceptable incidents have taken place.”

What Ms May didn’t mention was that she has already launched a review into care and integration policy. Fortunately, HSJ had revealed this project earlier in the day.

Capital perks

NHS Improvement continues to think up ways to incentivise NHS trusts to meet their financial target for 2016-17.

Last month, the regulator confirmed that trusts which better their control total will receive a revenue bonus payment. Now it wants to give those trusts “preferential access” to capital funding.

This, of course, means struggling trusts face further punishment – not only missing out on sustainability and transformation funding, but also on potential capital investment.  

The care conundrum

It’s been clear for many a year that a big funding system overhaul is needed to ensure older people can get the care and support they need, in a fair way. The issue has been avoided time and again, being much too difficult for politics, and probably the public, to get its head around.

Entirely understandable then that much of the response from readers to our revelation on Wednesday that the prime minister has set up a review to look at matters of care funding and policy has been along the lines: “Can kicked down the road. Predictable political response.”

Partly there is irritation the government isn’t acting now, when pressures are severe.

Peter Homa steps down

As the NHS faces some of the toughest years in its history yet, another giant of the service has announced their departure.

Peter Homa, chief executive of Nottingham University Hospitals Trust, has revealed he will retire in the summer – a real blow to NHS leadership.

What is striking is how quickly staff came forward to praise Mr Homa, whose first job in the NHS was as a hospital porter. They highlighted his patient focused approach and how he had led innovation at NUH while maintaining quality.

Police investigation launched into ‘tampered’ bags

Police are investigating whether saline bags at North Cumbria University Hospitals Trust have been tampered with.

The trust said it alerted police after a member of staff discovered “a small number of saline bags” at Cumberland Infirmary on 4 January, which appeared to have been tampered with.

Senior clinicians were alerted immediately and the trust said it followed its serious incident procedures.

It did not specify how the saline bags may have been tampered with but in a statement said it did not believe any patients had been adversely affected.