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.
Land of plenty
The government has pledged to stop raiding NHS capital budgets to prop up revenue spending.
But analysis of provider accounts reveal a new type of cap rev transfer has been taking place.
Last year, £206m (63 per cent) of the £327m raised from land sales helped shore up the Department of Health and Social Care’s revenue budget, rather than topping up its capital account.
Regular HSJ readers will know the Parliamentary and Health Service Ombudsman has had a difficult few years. However, under its current leadership, a new independent report has described the watchdog as moving from a state of “critical care” to “recovery”.
The independent report for the new ombudsman Rob Behrens also notes the PHSO delivers significant value for money and the new leadership is doing good work delivering for the public and stakeholders alike.
However, it also points to the widely known issue of the legislative basis on which the ombudsman works.
Complaints are filtered by MPs, and the ombudsman has no ability to launch its own investigations when it sees an obvious worthy issue. Compared with most ombudsman services in Europe and even in Scotland, the PHSO is, as Mr Behrens puts it, “lagging behind”.
Sleepless in Sussex
The Sussex health economy is thought to be among a small number of areas causing lost sleep for central regulators.
With seven clinical commissioning groups – five of which are in legal directions – in charge of commissioning and two out of three acute providers running large deficits, there is justification for senior officials’ worries.
Adam Doyle has gradually assumed control of the seven Sussex CCGs along with East Surrey, which forms part of the health economy and sustainability and transformation partnership area.
Mr Doyle seems to have impressed. Three of the CCGs – Crawley, Horsham and Mid Sussex, and East Surrey – have been partially lifted out of directions, with NHS England judging their governance to have improved in the period Mr Doyle has been in charge.
Try running too quickly and you’ll either fall over, or soon find you’re running on your own.
That seems to be what’s happened in Trafford, in Greater Manchester, where leaders of the CCG had envisioned all their GPs creating, and being employed by, a single primary care provider.
But it’s been clear for a while that things haven’t been going to plan. Now, an independent review has detailed the fallout.
Following a survey and interviews with GPs and other stakeholders, the review said there had been some “fierce” criticism of the previous leadership at the CCG, with confusion, anger, and a lack of trust around how the project had been developed.
In line with the recommendations, the CCG’s new leadership will go back to square one and start trying to build a “bottom up” consensus about the best way for primary care to scale up and collaborate.
In the run up to the NHS long-term plan, the realists in primary care had been steeling themselves to get pretty much sweet FA in terms of major investment in the next couple of years.
Step forward Matt Hancock, with a zest for “prevention” over “cure”, a professed zeal for “incremental reform”, and a declaration – in an extensive interview with HSJ – that the shift in resource from acute care to primary and community can’t wait and must begin next year.
In the same interview, Mr Hancock:
- Declared “big private health companies” won’t run integrated care – and he said he was up for negotiating with Labour for it to support legislation change put forward by the NHS
- Revealed his “big three” workforce shortage areas – but said there would be no national scheme to pay for EU NHS staff settled status
- Said changing flagship NHS targets would require a “watertight” case from clinicians
In the extensive interview last week, Mr Hancock told HSJ:
- Every trust should have a chief information officer reporting to their chief executive – and chiefs who don’t have that should be having a careful think
- That NHS home built tech could often be better and much better value than that bought in from elsewhere
- That the NHS needed to get its head around data and AI issues for itself – not outsource them to an expert global firm
- That IT firm bosses had told him they would adhere to his new standards for system interoperability
Trusts may be asked to stockpile certain types of equipment, according to the Department of Health and Social Care’s head of supply resilience David Wathey.
Mr Wathey’s words caveat the official government position that trusts should not stockpile medicinal supplies, over concerns this could destabilise supply chains.
If the DHSC advises trusts to stock up on certain types of equipment, local chiefs will have to overcome potential headaches, such as a lack of storage space and extra costs.
Screening out trouble
NHS England announced it will be overhauling all three national cancer screening programmes as part of the long-term plan. It has signed up the government’s first national cancer director, Sir Mike Richards, to lead a review.
The concerns started with the breast screening programme. In May, then health secretary, Jeremy Hunt was forced to explain to Parliament that a problem with an algorithm in the breast screening programme meant 450,000 women had not been invited to their final screening test.
But a review of the programme for Public Health England by management consultants PwC later found the IT system seemed to be fine and governance issues were actually, at least partly, to blame.