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.

The deficit won’t budge

The quarterly update on NHS trust finances told a familiar story – that despite providers continuing to deliver cost savings of more than 3 per cent, the deficit is not going away.

Worryingly for NHS Improvement, it’s now showing signs of getting worse despite the extra cash chucked in by the government in the Budget.

According to official figures published by NHSI, providers’ combined deficit is now forecast to grow to £930m by the end of 2017-18.

This would be almost double the £496m planned at the start of the year, and means the forecast has worsened by £300m over the last three months.

As HSJ revealed earlier this week, the deterioration has been largely driven by trusts with heavily backloaded savings’ plans.

The figures will pose further questions about the NHS’s ability to balance its books on the funding available, and could trigger a further clamp down from the Treasury.

Winter of discontent

The decision by the chair of East of England Ambulance Service Trust to commission a senior sector figure to “independently” review its operational management of the winter following allegations of avoidable patient harm and deaths is welcome.

Sarah Boulton revealed exclusively to HSJ that a “senior ambulance figure” was being lined up to scrutinise how the organisation has been operationally led this winter, which included a crisis-hit three weeks in which the trust recorded 138 “significant” delays, including one of 16 hours and another of 14 hours.

Ms Boulton also disputed allegations by a whistleblower that at least 40 patients were “harmed or died following significant ambulance delays”.

It will not be possible to judge the credibility or independence of the review until it is known who will carry it out and what the terms of reference are. It must also be transparent.

The trust has said there has been “no evidence of patient harm” as a result of ambulance delays “so far”. But Ms Boulton also said it had not completed assessing the 22 cases which it has deemed serious incidents.

Court in the middle

Public health contracts don’t always attract controversy, but a case in Lancashire is certainly getting people riled up.

Two NHS trusts have warned that missing out on a £100m, five year contract for school nursing and health visiting in the county will result in the loss of 160 jobs and up to £2m in funding – and it would threaten other services.

It follows Lancashire County Council’s choice of Virgin Care as its preferred provider.

The decision will likely have been a shock to Lancashire Care and Blackpool Teaching Hospitals trusts, the incumbent providers, given national leaders’ keenness for closer collaboration between the NHS and local authorities.

The trusts claim the council failed to apply the scoring criteria correctly, and other errors and deficiencies occurred during the bid evaluation process.

The trusts’ challenge forced a suspension of the contract award to Virgin, which the council subsequently applied to remove at a hearing last month.

But, according to a recently published summary of the hearing, the judge ruled lifting the suspension would undermine the trusts’ ability to provide other services.

Mr Justice Fraser cited an example given by one of the trusts that “lifting the automatic suspension would also result in the loss of senior staff who currently manage the full range of children’s services provided across all contracts”.

The case is now likely to go to trial in the spring, when the court will determine whether the council’s procurement was compliant with the rules.

Both trusts will continue to provide the services in the interim.

Teaching trust boss to retire

One of the longest serving chief executives in the NHS has announced he will retire this year.

Sir Andrew Cash will step down as chief executive of Sheffield Teaching Hospitals Foundation Trust in July, having led the organisation for 16 years.

He will continue to have a “significant role” in the region’s NHS, working part time as chief executive system leader for the South Yorkshire and Bassetlaw integrated care system.

Sir Andrew led one of the biggest trust mergers in 2001, bringing together five acute hospitals in Sheffield to create Sheffield Teaching Hospitals FT. It took on community health services in 2011.

System-wide problems in Oxfordshire

A Care Quality Commission review of health and social care in Oxfordshire has revealed the entrenched problems the area is facing with delayed discharges and integrated care. It was stark about the failure of organisations to work together.

The report into system integration found some patients “did not always receive safe discharges home”. It said it was “unacceptable” some patients had been sent home at 2am or 3am and found “widespread concerns” that others were passed on to social care providers without discharge letters. It also found issues with the accuracy of letters, with some failing to say when a patient’s medication had been stopped.

The regulator also reported “some discharges may have happened too soon”. Compared to the national average, lengths of stay in hospital in the region were shorter but readmissions were higher throughout 2016-17.