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.

Children wait too long for treatment

An HSJ investigation has revealed hundreds of young people assessed as needing specialist mental health treatment have been made to wait more than a year.

It found that 539 children assessed as needing Tier 3 child and adolescent mental health services care waited more than a year to start treatment.

It is not the first time that CAMHS has hit the headlines for the wrong reasons, with the Care Quality Commission branding services “fragmented” last year. The watchdog’s review of Children and Young People services, commissioned by prime minister Theresa May and published in March this year, also called for improvements to be delivered more quickly.

This is despite the services being prioritised by leaders across the NHS, government – all the way up to Mrs May herself.

The government’s pledge of £50m to trial a new four week access target for CAMHS as well as additional funding for new mental health support teams and designated leads at school is welcome.

Trust jumps two ratings in CQC inspection

Far from central London and the pinnacles of specialty medicine, down in the leafy suburbs, sits the capital’s first acute trust to be rated outstanding for its leadership.

Chief executive, Ann Radmore, and her colleagues have turned around the fortunes of Kingston Hospital Foundation Trust. In 2016 the CQC said overall it required improvement; in 2018 they think it’s outstanding.

That makes it only the second acute trust in England, by our count, to jump two grades in a single bound.

The inspectors were impressed with the way the trust created an environment where staff could be open and honest about problems so they could learn from mistakes. The CQC also praised on the trust’s “extremely caring” staff and the extra efforts they put into caring for patients with dementia.

Losing the dressing room

The new leaders of the troubled Barking, Havering and Redbridge University Hospitals Trust say they are committed to challenging any poor behaviour by senior medics.

But the decision to agree a secondment for medical director Nadeem Moghal, who had tried to take on some troublesome consultants, raises questions over this commitment.

A memo to clinical staff from the trust’s communications team, seen by HSJ, said Dr Moghal has been seconded to roles at the Royal College of Pathologists and Nuffield Trust think tank.

It comes after the publication of an NHS Improvement commissioned review earlier this month, which said his position “may be unsustainable over the longer term”.

The review had credited Dr Moghal with tackling “inappropriate behaviours amongst medical consultants”, saying he promoted “more structured job planning and greater transparency in relation to private patient activities”.

In football parlance, he had lost the dressing room.

The last straw

It seems self declared workforce champion Matt Hancock will have a fight on his hands after returning from the summer recess. The consultant’s committee chair has told HSJ in an exclusive interview that the senior medical workforce feels that it has been singled out for special punishment by the government’s disappointing pay offer announced last month.

Rob Harwood makes it clear that the union wants to get the 10 years of pay restraint reversed to prevent the entire consultant workforce from feeling undermined – he argued that consultants are already left feeling the least valued in the public sector.

With consultant shortages plaguing many trusts across the country, this feeling of frustration could have a serious impact on this increasingly disgruntled workforce.

Nurses let their feet do the talking

Many trusts in the country are undoubtedly suffering when it comes to workforce shortages in their accident and emergency. However, when staff begin to leave over worries about the safety of a trust’s services this is perhaps something which should cause extra alarm.

Shrewsbury and Telford Hospital Trust, a provider with widely reported A&E woes had seven nurses in total resign over July and June. The trust, which conducted exit interviews with these nurses, confirmed that at least one raised concern about the safety of its emergency department upon their departure.

It seems the trust is not the only one worried about these shortages, as concerns have also reached the regulator. In June, regional NHS Improvement directors made a plea to neighbouring trusts to offer support to SATH. However, none could answer this call owing to their own workforce woes.

Conflicts of interest

Only 5 per cent of NHS hospital trusts published a register of interests for their senior staff despite it being a contractual obligation.

NHS England published new guidance in 2017 on clinical commissioning groups, NHS trusts and NHS foundation trusts about managing potential conflicts of interest.

Organisations should publish a register of interests for their key managers at least once a year. But a survey by NHS England, the topline findings of which were published on an NHS Improvement bulletin last week, found only 5 per cent of acute trusts complied with the contractual duty.

NHS England launched a consultation on its plans in 2016 aiming to crackdown on executives earning money from consultancy and advisory positions and honorariums by demanding they be declared.