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.

Winners and losers

After four opportunities to bid for capital funds during the last two years, more than £2.3bn has been allocated for more than 100 NHS projects.

But, as HSJ analysis reveals, the financial requirements from the health service go far beyond the amount allocated by the government. 

Bid details obtained from the vast majority of NHS trusts show a combined capital request of nearly £9bn – close to the extra £10bn Sir Robert Naylor suggested should be channelled to sustainability and transformation partnerships in his 2017 review of the health service’s estate.

There have been some big winners but, inevitably, also some big losers. East London’s frustration at the process was evident when it spoke with HSJ.

And perhaps the most surprising of our findings was that a third of mental health trusts did not even submit bids to NHS England.

Balancing act

Matt Hancock looks set to fly in a digital brain from his previous department, with HSJ revealing Matthew Gould is the favoured contender to lead NHSX.

Mr Gould may come from outside the NHS, but he is no lightweight. His resume straddles the upper echelons of the civil service and leans heavily towards technology and diplomacy. He has previously served as British ambassador to Israel and is currently the government’s director general of digital and media, working within DCMS, the health secretary’s old department.

But, as chief executive of NHSX, his role will be a unique one. While the chief executive will (in theory) have sweeping powers over digital spending and strategy, enforcing standards and accelerating industry collaboration, it remains unclear how NHSX will function in practice. 

Both sides lose out

Trusts can be left high and dry when care homes run into trouble. This happened to East Kent Hospitals University Foundation Trust when the Care Quality Commission inspected Ami Lodge in Deal, where the trust had blockbooked all rooms.

Midway through the inspection – which rated the home “inadequate” – the trust gave notice on the deal and within weeks all NHS-funded patients had left. The home then closed and the trust has had to spot purchase beds elsewhere, likely to be a more expensive option.

Closer working between the NHS and social care providers could offer the chance to push up quality and address some of the NHS’ problems. When it goes wrong, both sides lose out.

No flapping

With just over a month to go before the UK leaves the European Union, the Department of Health and Social Care has so far spent £11m on no-deal contingency planning.

That’s according to health and social care secretary Matt Hancock, who also told Parliament on Tuesday he is confident the supply of medicines and devices to the NHS “will be unhindered” by a no-deal Brexit – provided “everyone does what they need to do”.

To realise Mr Hancock’s reassurances, the DHSC has – as part of its contingency planning – set up a “logistics hub” in Belgium (although the department has so far not specified precisely where) from which goods can be shipped on special routes to the UK.

The DHSC is now asking suppliers to register for the scheme, in a bid to help companies mitigate “severe disruption” to their supply chains – for example, caused by lengthy queues at ports. The logistics hub, which includes a distribution centre, will be operated by DHL but controlled by the DHSC.

Work life balance

A fortnight ago, HSJ reported a group of four MPs – three Conservative, one Labour – had raised concerns over the reappointment of the Dudley Group Foundation Trust’s chair Jenni Ord.

Ms Ord had had her tenure extended for three years, but the MPs were concerned this had happened while the findings of an investigation into whistleblowing claims made against some of its executive board members had not yet been made public.

Late on Tuesday, Ms Ord’s resignation was announced. The trust said she was leaving to pursue a “better work life balance”.

The new chief nurse’s vision

New chief nurse Ruth May certainly has her work cut out. There are challenges for nursing wherever she looks.

In her first major interview with HSJ, she did the inevitable call to celebrate the profession and encourage people to choose it as a career. She also called for an increase in the undergraduate supply into nursing.

Ms May was also right to acknowledge, when asked, about the risk of care being reduced to tasks – something repeatedly shown to be a negative for patients. However, her solution of enhanced leadership is hardly a cast-iron protection.

The chief nurse needs to be making the case around the table at NHS England, NHS Improvement and the Department of Health and Social Care that policy needs to support nursing and not undermine it, as it has been doing for too long.

Chickens coming home

DHSC has gone cap in hand to the Treasury for £600m because there’s official acceptance that its additional cost pressures were “unforeseen”.

The department says the pressures were outside its control. Meg Hillier, the committee chair, reckons the bailout is partly a result of the “creative accounting” which has masked the department’s real financial position. She said “chickens are now coming home to roost” after various controversial accounting measures had enabled the DHSC to “cover up the fact” that the money flowing into NHS trusts was insufficient.