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.

Another Mid Staffs?

The Liverpool community care scandal isn’t going away anytime soon.

Following major reviews by law firm Capsticks and Bill Kirkup into the overall management of Liverpool Community Health Trust, Dr Kirkup has now been asked to lead another inquiry into specific patient safety incidents that were never properly investigated.

It comes after Mersey Care Foundation Trust, which took over the services in 2018, identified around 17,000 incidents between 2010 and 2014 which require further scrutiny due to inadequate investigations and processes.

These are thought to include around 150 deaths which will now be closely examined.

Stevens backs the bots

Nearly two years ago, NHS England chief executive Simon Stevens told a crowd at the Health and Care Innovation Expo he would be investing in artificial intelligence in the next 12 months.

It has taken slightly longer than that, but, on Wednesday, Mr Stevens put some more meat on the bones, confirming NHS providers would be paid specifically to use artificial intelligence instead of clinical staff from April next year.

Mr Stevens said the focus for investments for getting machine learning into the NHS would be screening services, diagnostics and outpatient appointments. Screening is an obvious use case, with workforce shortages and a creaking IT system that needs overhauling regardless.

Missed opportunities

Last year, then health and social care secretary Jeremy Hunt issued a stark warning to private sector hospitals that they needed to get their house in order on safety after a series of deaths.

Now, another coroner has issued a warning about the ability of private hospitals to respond to deteriorating patients and to escalate care quickly enough.

Simon Healey was referred out of the NHS by his consultant Daniel McGrath, who was then operated on by the same consultant under privilege rights with Ramsay Health Care.

An expert told the inquest the leak in Mr Healey’s bowel should have been detected five days before his death. Had it been, Mr Healey would have survived.

The case is tragic, and while deaths like this may be rare, they do raise serious questions about how best to treat the rising number of patients needing treatment at a time when the NHS waiting list is growing.

The new (sort of) deputy chief

Amanda Pritchard, Guy’s and St Thomas’ FT chief executive, has been named as the chief operating officer of NHS England and Improvement – effectively a deputy chief executive post in the joint regulatory organisation.

Ms Pritchard’s name has been in the frame since the post was created on the infamous Breakfast Meeting of the Long iPad Pros, when NHSI chief Ian Dalton and NHSE deputy Matthew Swindells were sacked, and the modern NHS’ answer to the Night of the Long Knives.

Hard exit

It’s not often one can draw a parallel between Brexit and elective care, but, in the case of Nottingham Treatment Centre, the comparison (sort of) works.

On 28 July, private healthcare provider Circle will make what Nottingham University Hospitals Trust has dubbed a “hard exit” from the treatment centre when its contract expires.

On 29 July, NUH will start delivering services from the centre after winning a bitterly-contested procurement. However, capacity will be reduced significantly in the first few weeks and patient care will likely be disrupted.

A capital idea

A rumble of concern about dangerous NHS facilities and buildings has been discernible for some time, but may increasingly become a clamour audible to more politicians, as Following the Money explains this week.

Capital budgets have suffered for nearly a decade now, with revenue prioritised (though still under pressure, of course) and the former raided for successive years to get the latter in a slightly better position.

The official position is that, with the five-year NHS revenue deal fresh from last year, this autumn’s spending review is when the government should grant a good settlement for capital (and education and training, and public health).

Important context, however, includes the Brexit uncertainty and 31 October exit deadline, and the lack of a permanent government with the Tory leadership up for grabs, which could make it impossible for the Treasury to make any decisions and actually issue a proper spending review.

The perfect chaos, it seems, into which NHS England can punt an absolutely huge capital ask – a £50bn bond, to be exact – with a substantial political spin. 

Worth waiting for?

The eagerly-awaited interim NHS workforce plan has arrived and many will be disappointed with it.

The most pressing issues facing the NHS workforce are the level of nursing vacancies, staff shortages in other professions, the lack of continuing professional development training and the ongoing pensions crisis. On all these issues, the interim plan offers no definitive solution (although the Department of Health and Social Care made a subsequent announcement on pensions – see below). 

But there is much to commend in the plan. It does sensibly outline changes to the way the NHS manages its people and how individual providers are regulated by national bodies. This welcome recognition of the need to improve management culture is long overdue.

Pension pot half empty

The government’s announcement of a consultation on more flexible pensions arrangements has prompted many questions and provided little relief.

The 50:50 contributions arrangement the DHSC has said it is consulting on has already been widely criticised. “More work for half the pension. Why would anyone opt for that?” said one disgruntled HSJ reader.