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.
Gerada and Ham
Two well-known healthcare figures have been hired as co-chairs of a new “NHS assembly”, whose role is to “advise the joint boards of NHS England and NHS Improvement on delivery of the NHS long-term plan”.
The co-chairs are Clare Gerada, the prominent GP and one of the earliest and most vociferous critics of the Lansley NHS reforms of 2010-13, and Sir Chris Ham, who stepped down as King’s Fund chief executive at the beginning of the year and was one of the first champions of developing integrated care over competition in the NHS.
NHS Blood and Transplant has spent tens of millions on a new IT system – and got significantly less than it paid for.
HSJ revealed on Thursday that up to £17m of the £26m NHSBT spent modernising its IT systems would likely now have to be written off as a loss. With that money, NHSBT has built a system for communicating with hospitals and donors and managing contacts and is trying to salvage whatever else it can. Otherwise, it is still using the IT system that had been in place for over a decade.
A PwC review of the project revealed multiple failures which were evident from the beginning.
The review was specifically concerned about the heavy involvement of NHSBT’s chief executive at the time, Ian Trenholm, who has since left to lead the Care Quality Commission.
The CQC’s chair, Peter Wyman, says both the organisation and Mr Trenholm have reflected on “learnings” at NHSBT and had now ensured “robust governance around our own programme of change improvement”.
The NHS’ digital front door
The NHS App will, the long-term plan tells us, become the digital front door for patients.
But the NHS App is a long way from being in a position to manage this and grappling with well-rehearsed difficulties of making different IT systems communicate with one another (interoperability).
HSJ reported that NHS Digital has not been, as of yet, able to integrate the NHS App with any of the current providers of the 32 online and video GP consultations.
North central London is struggling to meet the 62-day target for cancer patients. Its latest papers reveal the aggregate proportion of patients entering treatment inside two months is at 77 per cent, below the 85 per cent target.
The sustainability and transformation partnership said there are issues with treatment pathways within trusts, where capacity issues cause delays, and delays accrue when patients are transferred from one trust to another for treatment.
Greater Manchester’s performance against the headline A&E target has been a growing concern ever since the devolution project started.
When devo (including a unique £450m transformation fund) was agreed with NHS England and the government, there was a clear expectation that it would enable the region to make faster progress and perform better than the rest of the country.
But its performance against the four-hour A&E target has consistently tracked below the national average since 2015, and it’s starting to fall further behind.
The latest stats show GM had another bad winter, with the four-hour standard being met in only around 82 per cent of cases over November, December and January.
In North by North West, Lawrence Dunhill now reveals this has triggered formal intervention from NHS England and NHS Improvement, due to performance dipping below the 85 per cent threshold agreed with GM for three consecutive months.
Costs vary on IVF
Commissioning inefficiencies are said to be “blocking” patients’ access to IVF, as new data reveals some areas are spending at least twice as much as others on a single cycle of fertility treatment, HSJ’s Sharon Brennan has revealed.
Information obtained via freedom of information requests by Fertility Fairness, a campaign group led by various charities, suggests 13 clinical commissioning groups spent at least £4,000 per cycle of IVF with their main provider in 2017-18, while six spent £2,000 or less.
Free IVF treatment on the NHS has become increasingly rationed over time, and the figures suggest more CCGs could offer more cycles of IVF if they were able to negotiate better prices.
Reconfiguring acute services is a long job, but it is likely no one in East Kent could have predicted how long it might take to even reach the starting line.
Two leading options had emerged. The first involves an expected consolidation of many services at the William Harvey Hospital in Ashford but with an accident and emergency department retained in Thanet. The second entails a surprise “new build” in Canterbury, dependent on housebuilding elsewhere in the city.
A public consultation had been mooted for spring 2018, but was pushed back and now seems unlikely to start before next year.
Delays in Essex
HSJ revealed on Monday that the planned merger of three Essex hospital trusts has been pushed back a year.
Setbacks to mergers are not uncommon, so the delay to the ambitious amalgamation of three mid-sized hospitals – Basildon and Thurrock University Hospitals Foundation Trust, Southend University Hospital FT and Mid Essex Hospital Services Trust – was perhaps inevitable.
But it represents a potentially costly blow. The trusts told HSJ it leaves question marks over a large chunk of capital – £118m – the Treasury provisionally allocated to them for a major clinical reorganisation, which they are not yet able to access.