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.

Mounting concerns

There are mounting concerns about the safety of maternity patients at Shrewsbury and Telford Hospital Trust. More than 100 cases are now set to be investigated by an independent expert and HSJ has revealed the Care Quality Commission has its own fears over the trust’s services.

The details of a CQC Section 31 enforcement notice letter to the trust, passed to HSJ, are frighteningly similar to the findings of an independent review into the death of one baby at the trust in 2009.

Baby Kate Stanton-Davies died because her mother was not properly risk assessed and opportunities were missed on multiple occasions.

While the investigations into alleged poor care are yet to confirm any concrete findings, the CQC’s fears, coming almost a decade after the same issues were identified, are extremely concerning.

Progress on pathology

The drive to consolidate pathology services is developing at a mixed pace across the country, but one area forging ahead is south east London, where health chiefs have put a large outsourcing contract on the market.

The procurement, run by the South East London Pathology Programme Board, is searching for a company to provide the full range of pathology disciplines for the trusts covered by the tender.

It comes ahead of the expiration of the contract for the current service (held by part NHS joint venture Viapath), and amid the ongoing drive from NHS Improvement to save £200m by 2021 by establishing pathology networks.

Pressing pause

Unions will be celebrating after NHS Improvement ordered a temporary stop to the creation of wholly owned subsidiary companies and any changes to existing companies.

As revealed by HSJ in July, NHSI are planning to consult on a new regulatory approach to trusts wanting to establish or change wholly owned subsidiary companies – and an announcement confirmed the consultation would start next month.

This year several trusts have attempted to set up subsidiaries, but subsequently abandoned the plans or had them rejected by the regulator.

Strikes are organised at two trusts by unions concerned that such companies will create a two tier workforce.

Delays

Back in the spring, it only took one look at the proposals to substantially integrate, but not actually merge, NHS England and Improvement to see they were going to be very difficult to make workable.

So it has proved, with one of the first hurdles – selecting the top tier of directors – not jumped, nearly six months after the first early details of the structure were published.

Meanwhile gossip rumbles on, with one question being whether any credible chief executives would be willing to take on a regional director role (with the enviable opportunity to report to the separate chief executives of both organisations). Another is which of the current postholders will be slotted into new jobs rather than move on.

Babylon calling

Babylon Healthcare has spent much of this year attempting to expand its relationship with the NHS, with mixed success.

In response to Freedom of Information Act requests from HSJ, 17 clinical commissioning groups disclosed contact with the company, which provides GP video consultations and other digital products.

Babylon says commissioners have known about plans to expand GP at hand for at least nine months and have failed to make provisions for this.

Blended by the light

While most agree that the NHS payment system needs to be reformed, there is never going to be a simple answer as to what should replace the “payment by results” tariff.

But NHS Improvement is attempting to push things in the right direction by introducing a “blended” approach between block contracts and activity based tariffs.

This would aim to capture the positive aspects of both extremes, and see contracts consisting of three parts; a fixed element; a variable element; and a risk share.

However, it is unclear whether the blended approach would be adopted for single care pathways, or for entire systems.

Essex Way

Potential council objections in Essex provide yet another reminder of the difficulties in reconfiguring hospital services.

Southend Council will formally decide next month if it will refer the Mid and South Essex sustainability and transformation partnership’s reconfiguration plans to the health and social care secretary.

It means that £118m of central funding allocated for the STP, which has set out plans to reconfigure services across three acute trusts (which are due to merge in April), is on hold until the matter is resolved.

London weighting

Leafy Kingston-upon-Thames is a far cry from the high cost high rises in London Bridge or Chelsea’s whitewashed town houses. But that doesn’t mean the cost of living is any less.

So says Ann Radmore, chief executive of Kingston Hospital Foundation Trust, who wants to redesign the “doughnut” salary supplement that sees staff in the centre of London get a 20 per cent addition to their salary, while staff in the outer boroughs get 15 per cent.

This “London weighting” is meant to make it easier for NHS staff to live and work in the middle of one of the world’s most expensive cities.