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.

Opt out

The timing of the news that 150,000 NHS patients have had their personal health details shared for years against their will could not be much worse.

It is barely a month since the new national data opt-out was launched, part of a safe new era of securely sharing NHS patient data to the benefit of all the government is fiercely promoting.

This vision has already taken a few knocks.

In early May, the government agreed to partially scrap an agreement that allowed NHS Digital to share patients’ confidential details with the Home Office to pursue low level immigration offences amid significant criticism.

Calls for the end of CQUIN

Bodies representing commissioners and providers came together this week to call for the end of the main pay for performance mechanism in NHS contracts.

NHS Providers and NHS Clinical Commissioners said the “commissioning for quality and innovation” scheme should be scrapped as systems moved to a more collaborative system from 2019-20.

CQUINs have been in place for nearly 10 years, and make part of a providers’ income conditional on demonstrating improvements in specified areas of patient care. They control more than £1bn nationally.

Long waits

Hospital trusts discovering large backlogs of patients waiting more than a year for treatment are a feature of acute healthcare at the moment.

The latest is Barts Health Trust, which saw 2,000 people wait more than 52 weeks for elective treatment over the four years its systems were not producing decent enough information to share with the national datasets.

The trust started reporting the data again last month and said no patients had come to harm as a result of the long waits. It would not disclose whether harm had come to a sub-set of patients, those identified as high risk .

In some cases a patient will chose to wait longer for treatment, to fit in with their plans or to see a specific consultant, but in many cases this is simply a capacity or administration issue

Grant departure

The town hall takeover of clinical commissioning groups in Greater Manchester has hit a glitch after the sudden resignation of one of its new joint leaders.

Theresa Grant, chief executive of Trafford Council, had also become accountable officer at Trafford CCG in April, as part of the region’s integration of health and social care services.

But three months later she has stepped down from both roles, after the local election in May resulted in Labour taking over the council’s leadership from the Conservatives.

The CCG’s corporate director of commissioning, Sara Radcliffe, will take on day-to-day responsibility of the commissioning body, with oversight provided by Salford CCG’s Anthony Hassall.

Trust issues and dreaming spires 

NHS Improvement has taken enforcement action against Oxford University Hospitals Foundation Trust for breaching the conditions of its licence due to ongoing problems with long waits, accident and emergency performance and unravelling finances.

The university city trust was under regulatory scrutiny throughout last year for missing major national targets.

It closed quarter four 2017-18, 14 percentage points short of the 95 per cent national target of admitting or discharging emergency patients within four hours. It also failed to meet referral to treatment targets.

OUHT’s finances continue to deteriorate. The trust has rejected its 2018-19 control total of a £23.7m surplus, and instead is forecasting a deficit of £25m, excluding sustainability and transformation funding. It finished the last financial year £31.7m short of plan.

Arbitration

Arbitration is the NHS version of the small claims court, although in one case HSJ reports this week, the claim was far from insubstantial.

The process kicks in when trusts and commissioners cannot agree who owes what at year end.

In Barking, Havering and Redbridge, more than £25m was disputed between the CCGs and their main acute provider Barking, Havering and Redbridge University Hospitals Trust.

The trust is having a difficult time financially, with a £50m deficit blackhole opening up towards the end of 2017-18. 

The need for arbitration processes are embarassing for the system.

In November, HSJ reported the findings from arbitration between Brighton and Sussex University Hospitals Trust and NHS England, which NHS England lost. NHS England tried to keep the result secret but accidentally emailed it out.