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.
In her first interview with HSJ, NHS Improvement chair Baroness Dido Harding has made a clear statement of intent about how the regulator will act when it comes to NHS managers who “cross a moral line”.
In short, the Conservative peer was clear that for those managers who fall below the standard they will not work in the NHS again. Interestingly, she said to deliver this would require “a firmer fit and proper person test”. She also referenced the work being undertaken by the Care Quality Commission and Department of Health and Soical Care to review the regulations following the report by Bill Kirkup into failings at Liverpool Community Health Trust.
But readers may welcome Baroness Harding’s nuanced approach to leaders that fail. She rightly recognised that failing leaders are not always bad people, some have simply been promoted into senior roles without the necessary training and coaching to support them. She intends to do more on the NHS management of talent. She told HSJ: “If I am really honest, I am quite shocked by the absence of the sort of talent management and performance management at the senior levels in the NHS compared to other organisations.”
Sticking plaster statistics
Cast your mind way, way back to the beginning of the very long winter, and you will recall there was a big row over whether changes to the rules on emergency activity coding were going to paint too flattering a picture of waiting times performance.
The UK Statistics Authority got involved in January, raising concerns over the accuracy of national accident and emergency performance data.
The issue arose when then NHSI chief executive Jim Mackey, shortly before departing, sent a letter to all trusts, which the regulator maintains was intended to iron out “inconsistencies” between trusts on which admissions were included in A&E data.
The move was viewed as a sticking plaster solution to try and address a long standing issue quickly before winter.
It tells us two important things.
First, some trusts’ activity data was “artificially inflated” as a result of changes made following the Mackey letter.
Second, and most importantly, the effect was pretty negligible overall – between 0.11 and 0.18 percentage points on the national figure for performance against the four hour A&E target.
The NHS England review said that overall about 26,000 admissions were wrongly included over a three month period which saw 6 million such episodes overall.
However – these would have been concentrated in a few trusts rather than evenly distributed.
Carillion carry on
It is nearly three months since the downfall of Carillion but the reverberations are still being felt in the NHS.
The biggest impact was felt by Sandwell and West Birmingham and Royal Liverpool and Broadgreen University Hospitals trusts, where Carillion was building new privately financed hospitals each costing more than £300m.
Neither have agreed terms with a new contractor to pick up Carillion’s work and finish the job.
HSJ understands both trusts have identified their preferred builder, but key details are yet to be ironed out with the moneymen (PwC) and the government over the longer term plans for completing and maintaining the hospitals.
These are highly complex talks, not helped by the number of different parties involved, but Sandwell and West Birmingham chief executive Toby Lewis says he is growing increasingly concerned about the lack of progress.
In a candid interview with HSJ, Mr Lewis said the clinical risks of further delays to the new Midland Metropolitan Hospital need to be “paramount” when considering the way forward.
While he stressed no party to the discussions was being unhelpful, he was frustrated that a solution had not been agreed.
It is a change of tone compared to the immediate aftermath of Carillion’s liquidation when Mr Lewis was “cautiously optimistic” that a new builder could be found quickly.
Cancelled cancer operations
More than 500 cancer operations were cancelled by hospital trusts in England due to winter pressures.
HSJ received information from 81 acute NHS trusts, of which 43 said they had cancelled at least one operation between December and February.
Across those 43 trusts, 530 operations were cancelled. This included some diagnostic procedures such as biopsy.
NHS officials had recommended cancelling most elective hospital care during January and February, while pressures were most severe, but stated that “cancer operations and time-critical procedures should go ahead as planned”.
Phoenix in order
Securing capital funding for major estates plans has been an unenviable task in the NHS over the years.
But that job might get easier if the government approves a business case that would enable the NHS and private sector to set up joint ventures to deliver multimillion pound projects.
“Project Phoenix” would see six regional health infrastructure companies set up as the “delivery route” for trusts and sustainability and transformation partnerships’ estates transformation.
The plan came to light last year, but since then its implementation has been delayed – for reasons that have not yet been explained by Phoenix’s architects Community Health Partnerships.
Should the business case be approved, a bundle of capital projects in the South West and the Midlands will be first in the queue to be delivered through the new public/private partnerships.