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.

An unwanted 1990s revival

Is the NHS heading back to the infamously dark days of 1990s? NHS England director for acute care Keith Willett insists the health service was not facing a crisis. But he did suggest the NHS has not been under so much pressure since the 1990s.

Professor Willett told Today on Radio 4: “I have been in the NHS a very long time, many decades now, and I have seen similar pressures. Way back in the nineties we saw them. I have seen difficulties like this in the past.”

He also warned that further cancellations to elective operations were “certainly a possibility” and the cold weather forecast for the weekend indicated things would get tougher.

Professor Willett was sent out to face the media following the NHS England announcing late on Tuesday an extension on the moratorium on non-urgent hospital operations and other significant measures to deal with “sustained pressure” on the emergency care system.

These include suspending penalties for breaching rules on mixed sex accommodation and an order to defer day case procedures and routine outpatient appointments “where this will release clinical time for non-elective care”.

Crystal clear future 

HSJ’s experts have looked into their crystal balls and predicted what is in store as the NHS celebrates its platinum anniversary.

So, before the end of March, NHS England will make clear that the service will not hit the 95 per cent four hour accident and emergency target in 2018-19 or make any more than a marginal dent in the elective waiting list.

Meanwhile, the NHS’s financial plight will not meaningfully improve, efficiency asks will be eye watering and the Treasury’s grip will increase.

There will be rows and legal challenges over growing restrictions on drugs and treatments that NHS England declares “unaffordable” or of “low clinical value”.

Also in the commissioning sector, “accountable care” as a label within the NHS will die before the first new organisation gets going. On the provider side, alliances, chains and even mergers are back in favour.

This year will also be crucial for primary care (which may have its “Uber moment”) and mental health (which faces “a battle to protect its new, relative, wealth”.)

At the top of the shop, we predict Jeremy Hunt will remain health secretary for a while longer and “the merger which dare not speak its name between NHS England and NHS Improvement” will continue.

The editor sums up: “The NHS has known grimmer years than the one in which it will mark its 70th birthday, but probably not one that will feel as tough…

“HSJ apologises for the fact that many of our predictions will be about as welcome as being given the on-call shift on new year’s eve. There will be success and innovation in 2018, and the service is still developing broadly in the right direction. There will also (we trust) be time to celebrate the NHS’s achievements since 1948, which have seen it established unchallenged as the pride of the nation.”

Slow change on racial bias

The latest race equality data shows that there is still “much, much more work to do” if the NHS is remove racial bias from how its staff are treated.

In 2016-17, there was an England wide reduction in the likelihood of black and minority ethnic staff facing a formal discipline process compared to white colleagues – but behind this national improvement, HSJ analysis reveals wide variation.

BME staff were 1.4 times more likely to be disciplined compared to their non-BME colleagues, down from 1.56 in the previous year.

However, while the chance of a BME person entering a formal disciplinary process compared to a white person has reduced at 48 per cent of trusts since 2015-16, it increased in 42 per cent.

Looking at trusts’ workforce race equality standard data, in 2016-17 BME staff at one trust were nine times more likely to enter the disciplinary process compared to white colleagues.

Robert Kline, who was NHS England director for WRES and engagement until September, said: “What you have is some trusts making very significant improvement, quite a few trusts making a bit of improvement and the others largely flatlining, which is why there is an improvement but let’s not get too carried away.”

Trust chiefs recognised in new year’s honours

The chief executive of University Hospitals of Morecambe Bay Foundation Trust was among the senior NHS figures named in the new year’s honours list.

Jackie Daniel becomes a dame for services to healthcare. She became chief executive of the trust in 2012, and in 2015 led it out of special measures. The trust was rated good in February 2017 as it continued to recover from a high profile maternity care scandal.

Also becoming a dame is Angela Pedder. She stepped down as chief executive of Royal Devon and Exeter FT after 19 years in 2017, and was also the lead for the Wider Devon Sustainability and Transformation Partnership and the Northern, Eastern, and Western Devon success regime.

Outgoing Royal College of Surgeons president Clare Marx received a damehood too.

CBEs were awarded to NHS England chief financial officer Paul Baumann, former NHS England London director Anne Rainsberry, CQC chief inspector for adult social care Andrea Sutcliffe, and Professor Tim Briggs who leads the Getting It Right First Time programme.

Jackie Bene, chief executive of Bolton FT, was named as an OBE, as was former national patient safety director Mike Durkin.